A totally mini-invasive approach for colorectal laparoscopic surgery

作     者：Gabriele Anania Mirco Santini Lucia Scagliarini Alice Marzetti Laura Vedana Serafino Marino Claudio Gregorio Giuseppe Resta Giorgio Cavallesco 

作者机构：Department of SurgeryArcispedale S.AnnaMedical University of Ferrara44121 FerraraItaly 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2012年第18卷第29期

页      面：3869-3874页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：手术方法 结直肠癌 腹腔镜 体外循环 评价标准 液体输送 功能恢复 大肠癌 

摘      要：AIM:To study the short-term outcome of patients treated with laparoscopic right colectomy and how intracorporeal anastomosis has improved the ***:We retrospectively examined all patients affected by colorectal cancer who underwent a laparoscopic right colectomy between January 2006 and December 2010 in our *** evaluation criteria were:diagnosis of colorectal carcinoma at presurgical biopsy,elective surgery,and the same *** excluded:emergency surgery,conversions from laparotomic colectomy,and other *** endpoints we examined were:surgical time,number of lymph nodes removed,length of stay(removal of nasogastric tube,bowel movements,gas evacuation,solid and liquid feeding,hospitalization),and major ***-two patients were divided into two groups:intracorporeal anastomosis(39 patients)and extracorporeal anastomosis(33 patients).RESULTS:Significant differences were observed between intracorporeal vs extracorporeal anastomosis,respectively,for surgical times(186.8 min vs 184.1 min,P 0.001),time to resumption of gas evacuation(3 d vs 3.5 d,P 0.001),days until resumption of bowel movements(3.8 d vs 4.9 d,P 0.001),days until resumption of liquid diet(3.5 d vs 4.5 d,P 0.001),days until resuming a solid diet(4.6 d vs 5.7 d,P 0.001),and total hospitalization duration(7.4 d vs 8.5 d,P 0.001).In the intracorporeal group,on average,19 positive lymph nodes were removed;in the extracorporeal group,on average,14 were removed P 0.001).Thus,intracorporeal anastomosis for right laparoscopic colectomy improved patient outcome by providing faster recovery of nutrition,faster recovery of intestinal function,and shorter hospitalization than extracorporeal ***:Short-term outcomes favor intracorporeal anastomosis,confirming that a less traumatic surgical approach improves patient outcome.