Lozano DG, Montaya RJ, Aguilar SOA, Oviedo MVM, Gamiño OFJ, Pérez CF

Language: Spanish
References: 28
Page: 301-304
PDF size: 56.94 Kb.

ABSTRACT

Objective: To describe the experience with totally laparoscopic surgery of the left colon and to assess its results.
Setting: Third level health care hospital.
Design: Descriptive, observational study, without control group.
Patients and methods: We studied 20 patients, all were subjected to sigmoid and/or descending colon resection through non-assisted laparoscopy, during a 7 years period. Inclusion criteria were: benign disease of the colon, body mass index below 30 kg/m², and belonging to classification ASA I-II. Exclusion criteria were: malignant disease of the colon, uterine myomatosis, colonic fistula, with cardiovascular or metabolic decompensation, or psychiatric disorders. Assessed variables were: age, gender, diagnosis, surgical time, pain, start of oral ingestion, complications, days of hospital stay, aesthetic appearance, and disability days.
Results: Twenty patients were operated, 13 women and 7 men, average age of 47 years. Indication for surgery were: diverticular disease, 9: dolichosigmoid, 10; rectal prolapse, 1. Surgical time averaged 242 minutes in the first 10 patients and 127 minutes for the remainder 10 patients. Oral ingestion was started on the second post-operative day; average hospital stay was of 4 days, and working disability days averaged 12. No deaths occurred.
Conclusion: Resection of the sigmoid and/or descending colon by total laparoscopy is a safe surgery in well-selected patients and practiced by a surgical team with experience in open and advanced laparoscopic surgery.

REFERENCES

1. Perissat J. Laparoscopic surgery: A pioneer’s point of view. World J Surg 1999; 23: 863-8.

2. Silecchia G, Perrotta N, Basso N. Laparoscopic surgery of the colorectum: analysis of results of the National Registry of the Italian Society of Endoscopic Surgery and New Technologies CS. I.C.E.S. Chir Ital 2001; 53: 447-52.

3. Wexner SD, Moscovitz ID. Colectomía mediante laparoscopia en enfermedades diverticular y de Crohn. Clin Quir Norteam 2000; 80: 1357-79.

4. Stage JG, Schulze S, Moller P, Overgaard H, Andersen M, Rebsdorf-Pedersen VB, et al. Prospective randomized study of laparoscopic versus open colonic resection for adenocarcinoma. Br J Surg 1997; 84: 391-6.

5. Hackert T, Uhl W, Buchler MW. Specimen retrieval in laparoscopic colon surgery. Dig Surg 2002; 19: 502-6.

6. Targarona EM, Gracia E, Rodríguez M, Cerdán G, Garriga J, Trias M. Cirugía laparoscópica asistida con la mano. Cir Esp 2002; 72: 95-102.

7. Senagore AJ, Erwin-Toth P. Care of the laparoscopic colectomy patient. Adv Skin Wound Care 2002; 15: 277-83; quiz 284-5.

8. Dean PA, Beart RW Jr, Nelson H, Elftmann TD, Schlinkert RT. Laparoscopic-assisted segmental colectomy: early Mayo Clinic experience. Mayo Clin Proc 1994; 69: 834-40.

9. Senagore AJ, Madbouly KM, Fazio VW, Duepree HJ, Brandy KM, Delaney CP. Advantages of laparoscopic colectomy in older patients. Arch Surg 2003; 138: 252-6.

10. Hildebrandt U, Kessler K, Plusczyk T, Pistorius G, Vollmar B, Menger MD. Comparison of surgical stress between laparoscopic and open colonic resections. Surg Endosc 2003; 17: 242-6.

11. Agachan F, Joo JS, Weiss EG, Wexner SD. Intraoperative laparoscopic complications. Are we getting better? Dis Colon Rectum 1996; 39(10suppl): 514-9.

12. Athanasakis H, Tsiaoussis J, Vassilakis JS, Xynos E. Laparoscopically y assisted subtotal colectomy for slow-transit constipation. Surg Endosc 2001; 15: 1090-2.

13. Heili MJ, Flowers SA, Fowler DL. Laparoscopic-assisted colectomy: a comparison of dissection techniques. JSLS 1999; 3: 27-31

14. Lozano DG, Montoya RJ, Aguilar SOA, Oviedo MVM, Gamiño OFJ, Perez CF. Resección de sigmoides y/o colon descendente pro vía laparoscópica no asistida. Experiencia en once pacientes. Cir Gen 2000; 22: 195-200

15. Gibson M, Byrd C, Pierce C, Weight F, Norwood W, Gibson T, et al. Laparoscopic colon resections: a five-year retrospective review. Am Surg 2000; 66: 245-8; discussion 248-9.

16. Khoury G, Abiad F, Hussein M, Bikhazi K, Khalifeh M, Jabbour S, et al. Laparoscopic colorectal resections. Initial experience at the AUB-MC. J Med Liban 1999; 47: 159-63.

17. Liberman MA, Phillips EH, Carrol BJ, Fallas M, Rosenthal R. Laparoscopic colectomy vs traditional colectomy for diverticulitis. Outcome and costs. Surg Endosc 1996; 10: 15-8.

18. Blanco-Engert R, Díaz Maag R, Gascón M, Delgado Gomis F, Rosenthal R, Weiner R. Complicaciones postoperatorias en cirugía laparoscópica del colon. Cir Esp 2002; 72: 232-9.

19. Senagore AJ, Duepree HJ, Delaney CP, Brady KM, Fazio VW. Results of a standardized technique and postoperative care plan for laparoscopic sigmoid colectomy: a 30-month experience. Dis Colon Rectum 2003; 46: 503-9.

20. Schiedeck TH, Roblick UJ, Dupree HJ, Bruch HP. Hand port-assisted laparoscopic surgery [abstracts]. Zentralbl Chir 2001; 126: 243-7.

21. Dunker MS, Stiggelbout AM, van Hogezand RA, Ringers J, Griffioen G, Bemelman WA. Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn’s disease. Surg Endosc 1998; 12: 1334-40.

22. Lin KM, Ota DM. Laparoscopic colectomy for cancer: an oncologic feasible option. Surg Oncol 2000; 9: 127-34.

23. Bardram L, Funch-Jensen P, Kehlet H. Rapid rehabilitation in elderly patients after laparoscopic colonic resection. Br J Surg 2000; 87: 1540-5.

24. Dwivedi A, Chahin F, Agrawal S, Chau WY, Tootla A, Tootla F, et al. Laparoscopic colectomy vs open colectomy for sigmoid diverticular disease. Dis Colon Rectum 2002; 45: 1309-14; discussion 1314-5.

25. Carbajo Caballero MA, Martín del Olmo JC, Blanco Alvarez JI, Martín Acebes F, De la Cuesta de la Llave C, Atienza Sánchez R, et al. Acute diverticulitis and diverticular disease of the colon: a safe indication for laparoscopic surgery. Rev Esp Enferm Dig 2000; 92: 718-25.

26. Glomsaker T, Facrden AE, Reiertsen O, Bjaerke T, Edwin B, Naesgaard JM, et al. Laparoscopic colorectal surgery. The first experiences from the Central Hospital of Akershus [abstract]. Tidsskr Nor Laegeforen 1998; 118: 4378-81.

27. Paik PS, Beart EW Jr. Laparoscopic colectomy. Surg Clin North Am 1997; 77: 1-13.

28. Roig JV, Solana A, Alós R. Tratamiento quirúrgico y resultados del cáncer de colon. Cir Esp 2003; 73: 20-4.