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Is fascial closure required for a 12-mm trocar?A comparative study on trocar site hernia with long-term follow up

World Journal of Clinical Cases 2023年第2期11卷 357-365页

作者： Santi Krittiyanitsakun Chawisa Nampoolsuksan Thikhamporn Tawantanakorn Tharathorn Suwatthanarak Nicha Srisuworanan Voraboot Taweerutchana Thammawat Parakonthun Chainarong Phalanusitthepha Jirawat Swangsri Thawatchai Akaraviputh Asada Methasate Vitoon Chinswangwatanakul Atthaphorn Trakarnsanga Minimally Invasive surgery Unit Department of SurgeryFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand

BACKGROUND Despite the infrequency of trocar site hernias(TSHs),fascial closure continues to be recommended for their prevention when using a≥10-mm *** To identify the necessity of fascial closure for a 12-mm nonbladed trocar incision in minimally invasive colorectal *** Between July 2010 and December 2018,all patients who underwent minimally invasive colorectal surgery at the Minimally Invasive surgery Unit of Siriraj Hospital were retrospectively *** patients underwent cross-sectional imaging for TSH *** characteristics were *** rates of TSH and postoperative results were *** Of the 254 patients included,70(111 ports)were in the fascial closure(closed)group and 184(279 ports)were in the nonfascial closure(open)*** median follow up duration was 43 *** follow up,three patients in the open group developed TSHs,whereas none in the closed group developed the condition(1.1%vs 0%,P=0.561).All TSHs occurred in the right lower *** whose drains were placed through the same incision had higher rates of TSHs compared with those without the *** open group had a significantly shorter operative time and lower blood loss than the closed *** Routine performance of fascial closure when using a 12-mm nonbladed trocar may not be ***,further prospective studies with cross-sectional imaging follow-up and larger sample size are needed to confirm this finding.

关键词： Trocar site hernia Port site hernia Fascial closure laparoscopic colorectal surgery Nonbladed trocar

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Specimen retrieval approaches in patients undergoing laparoscopic colorectal resections:a literature-based review of published studies

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Gastroenterology Report 2014年第4期2卷 251-261页

作者： Muhammad S.Sajid Muhammad I.Bhatti Parv Sains Mirza K.Baig Department of General&laparoscopic colorectal surgery Worthing HospitalWorthingUK Department of General surgery Queen Elizabeth HospitalKings Lynn NHS Foundation TrustKings LynnUK

Objective:To review the published studies reporting various specimen retrieval incisions being used by colorectal surgeons in patients undergoing laparoscopic colorectal resections(LCR).Methods:Standard medical electronic databases were searched to find relevant articles and a summary conclusion was ***:There were 43 studies reporting various approaches used for the purpose of specimen retrieval in 2388 patients undergoing *** most common approaches were periumbilical midline incision(1260 reported case in the literature),transverse incision(583 reported cases in the literature)in the right-or left iliac fossa,depending on the side of colonic resection,and Pfannensteil incision(293 reported cases in the literature).Periumbilical midline incision was associated with the higher risk of developing incisional hernia(odds ratio 53.72;95%confidence interval 7.48–386.04;Z=3.96;P=0.0001).In terms of surgical site infection(SSI),there was no difference between the three common approaches to specimen *** and transvaginal approaches were associated with higher risk of ***:Midline,transverse and Pfannensteil incisions were the most commonly used approaches for specimen retrieval following *** incision was associated with higher risk of incisional *** of SSI was similar in all three common *** transanal and transvaginal approaches pose a higher risk of *** conclusions are based on the combined outcome of published case series,case reports and comparative ***,controlled trials with longer follow-up are required before recommending the routine use of any approach for specimen retrieval in patients undergoing LCR.

关键词： colorectal cancer laparoscopic colorectal surgery umbilical incision transverse incision anal retrieval vaginal retrieval

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Hand-assisted laparoscopic VS open right hemicolectomy:short-term outcomes in a single institution from China

Hand-assisted Laparoscopic VS open right hemicolectomy:short...

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2011年浙江省肛肠外科学术大会暨结直肠肛门疾病诊治新进展学习班

作者： Department of colorectal and Anal surgery,The first affiliated hospital of college of Medicine, Zhejiang University,Zhejiang 310003,China Qin-Song Sheng Jian-Jiang Lin Wen-Bin Chen Feng Ye Fan-Long Liu Yan-Dong Li Cai-Zhao Lin Jin-Hai Wang Xiang-Ming Xu Han-Ju Hua Xi-Le Zhou

aim To compare the perioperative parameters and short-term outcomes of hand-assisted laparoscopic colectomy(HALC) and open colectomy(OC) for the treatment of patients with cancer of right *** Patients who were scheduled to perform right hemicolectomy between August 2009 and December 2010 were randomized into either HALC or OC *** were excluded if they had synchronous cancers,hepatic metastases,acute intestinal obstruction or intestinal *** the operations in the two groups were performed by a single surgical *** outcomes included age,sex,body mass index(BMI),American Society of Anesthesiologists(ASA) class,prior abdominal surgery,distribution of tumors and histopathologic *** the later included length of incision,operative time,estimated blood loss,conversion rate,number of lymph nodes retrieved,postoperative pain score,time to return of bowel function, postoperative complications,duration of hospital stay and total *** One hundred and sixteen patients with cancer of right hemicolon(HALC=59,OC=57 ) were *** two groups of patients were similar in age,sex distribution,BMI,ASA class,previous abdominal *** significant difference was observed between the two groups in terms of distribution of tumors and the final histopathological *** had a significantly shorter incision length and longer operative time than *** in the HALC group had significantly less operative blood loss,less pain and earlier passage of flatus after operation than those in the OC *** number of lymph nodes recovered in the specimen and the overall postoperative complications was comparable in the two *** post-operative duration of hospital stay was significantly shorter in the HALC group,while the median overall costs in the HALC group were significantly higher than that in the OC group. conclusion The results from the present study demonstrate that the HALC is a valid surgical approach for can

关键词： Hand-assisted laparoscopic surgery Hand-assisted laparoscopic colectomy Open colectomy Colon cancer laparoscopic colorectal surgery

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