TY - JOUR
T1 - Benefits of laparoscopic-assisted colectomy for colon polyps
T2 - A case-matched series
AU - Young-Fadok, Tonia M.
AU - Radice, Elisabetta
AU - Nelson, Heidi
AU - Scott Harmsen, W.
PY - 2000
Y1 - 2000
N2 - Objective: To clarify the true benefits of laparoscopic assisted colectomy by comparing clinical outcomes from a series of laparoscopic right colectomies with matched open colectomies, all performed for the singular indication of polyp not amenable to colonoscopic removal. Patients and Methods: A retrospective case-matched study was performed of consecutive patients undergoing laparoscopic-assisted right hemicolectomy for polyps between January 1992 and July 1997. Each case was matched to a control undergoing the equivalent open procedure for the same indication during the same time period. Results: Thirty-eight patients undergoing laparoscopic-assisted right hemicolectomy for polyps were identified, and matches were found. The conversion rate was 18.4% (7/38), 21.4% early in the series and 10% in later experience. Operative times were longer for laparoscopic-associated colectomy (median, 208 minutes vs 150 minutes, P<.001). Laparoscopic-assisted colectomy resulted in shorter postoperative ileus (time to flatus, 3.0 vs 4.0 days, P<.001; time to bowel movement, 3.5 vs 5.0 days, P<.001) and in earlier tolerance of regular diet (3.5 vs 6.0 days, P<.001). Fewer days of narcotic administration were required by the laparoscopic group (3.0 vs 4.5 days, P<.001). This resulted in a significantly shorter length of hospital stay (4.0 vs 7.0 days, P<.001). There was no significant difference in the incidence of postoperative complications. Conclusions: Laparoscopic right hemicolectomy has significant patient benefits. These benefits are apparent when procedures of equal complexity and equivalent indications are compared. Laparoscopic-assisted resection has become our preferred approach for polyps not amenable to colonoscopic polypectomy.
AB - Objective: To clarify the true benefits of laparoscopic assisted colectomy by comparing clinical outcomes from a series of laparoscopic right colectomies with matched open colectomies, all performed for the singular indication of polyp not amenable to colonoscopic removal. Patients and Methods: A retrospective case-matched study was performed of consecutive patients undergoing laparoscopic-assisted right hemicolectomy for polyps between January 1992 and July 1997. Each case was matched to a control undergoing the equivalent open procedure for the same indication during the same time period. Results: Thirty-eight patients undergoing laparoscopic-assisted right hemicolectomy for polyps were identified, and matches were found. The conversion rate was 18.4% (7/38), 21.4% early in the series and 10% in later experience. Operative times were longer for laparoscopic-associated colectomy (median, 208 minutes vs 150 minutes, P<.001). Laparoscopic-assisted colectomy resulted in shorter postoperative ileus (time to flatus, 3.0 vs 4.0 days, P<.001; time to bowel movement, 3.5 vs 5.0 days, P<.001) and in earlier tolerance of regular diet (3.5 vs 6.0 days, P<.001). Fewer days of narcotic administration were required by the laparoscopic group (3.0 vs 4.5 days, P<.001). This resulted in a significantly shorter length of hospital stay (4.0 vs 7.0 days, P<.001). There was no significant difference in the incidence of postoperative complications. Conclusions: Laparoscopic right hemicolectomy has significant patient benefits. These benefits are apparent when procedures of equal complexity and equivalent indications are compared. Laparoscopic-assisted resection has become our preferred approach for polyps not amenable to colonoscopic polypectomy.
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U2 - 10.4065/75.4.344
DO - 10.4065/75.4.344
M3 - Article
C2 - 10761487
AN - SCOPUS:0034086031
SN - 0025-6196
VL - 75
SP - 344
EP - 348
JO - Mayo Clinic proceedings
JF - Mayo Clinic proceedings
IS - 4
ER -