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The
learning curve in laparoscopic colectomies: results and considerations
Slijper N., Eldar S., Madi
H., Koppelmann T., Matter I.
Dept. of Surgery, Bnai-Zion
Medical Center,
Haifa
Background
Laparoscopic colon resection was first reported
in 1990. Since then, numerous studies have documented the benefits of the
procedure: less pain, fewer complications, lower overall costs, and shorter
length of stay and return of bowel function.
This approach was discussed during the years as
a proper method for benign and malignant illnesses and for inflammatory and
non-inflammatory states.
Methods
A consecutive series of patients underwent
laparoscopic colectomy from Jan 2000 through Sept. 2004 at Bnai Zion
Med. Center
was analyzed. All Patients requiring
sigmoid, rectosigmoid, rt. Colectomy, lt. Colectomy, APR and total
colectomy for all colonic pathologies were included.
Results
A total
of 128 cases from 152 were detected.
Conversion rate was 12/128 (9.3%) cases due to multiple adhesions other technical
difficulties or injury to the left ureter (n=1), colon (n=1) or aorta
(n=1). Anastomosis was performed intracorporeally using endostaplers in the
majority of cases (116/124). The operations were performed either by a
senior surgeon (n=112) or by a resident directed by a senior surgeon
(n=15). Post operative complication rate was 17.9%(23/128).
Conclusion
Laparoscopic Colectomy is a safe and
feasible procedure that improves short-term outcome. Several recent
articles have confirmed the safety of laparoscopy in colorectal and other
types of abdominal cancer when the procedure is performed by experienced
surgeons.
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