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colorectal and laparoscopic surgery

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https://www.readbyqxmd.com/read/28917020/predicting-opportunities-to-increase-utilization-of-laparoscopy-for-rectal-cancer
#1
Deborah S Keller, Jiejing Qiu, Anthony J Senagore
BACKGROUND: Despite proven safety and efficacy, rates of laparoscopy for rectal cancer in the US are low. With reports of inferiority with laparoscopy compared to open surgery, and movements to develop accredited centers, investigating utilization and predictors of laparoscopy are warranted. Our goal was to evaluate current utilization and identify factors impacting use of laparoscopic surgery for rectal cancer. METHODS: The Premier™ Hospital Database was reviewed for elective inpatient rectal cancer resections (1/1/2010-6/30/2015)...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916895/the-cost-of-conversion-in-robotic-and-laparoscopic-colorectal-surgery
#2
Robert K Cleary, Andrew J Mullard, Jane Ferraro, Scott E Regenbogen
BACKGROUND: Conversion from minimally invasive to open colorectal surgery remains common and costly. Robotic colorectal surgery is associated with lower rates of conversion than laparoscopy, but institutions and payers remain concerned about equipment and implementation costs. Recognizing that reimbursement reform and bundled payments expand perspectives on cost to include the entire surgical episode, we evaluated the role of minimally invasive conversion in total payments. METHODS: This is an observational study from a linked data registry including clinical data from the Michigan Surgical Quality Collaborative and payment data from the Michigan Value Collaborative between July 2012 and April 2015...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28916861/predictors-of-adherence-to-enhanced-recovery-pathway-elements-after-laparoscopic-colorectal-surgery
#3
Juan Mata, Julio F Fiore, Nicolo Pecorelli, Barry L Stein, Sender Liberman, Patrick Charlebois, Liane S Feldman
INTRODUCTION: Enhanced recovery pathways (ERP) include a bundle of evidence-based preoperative, intraoperative, and postoperative interventions that together reduce morbidity and length of stay after colorectal surgery. Increased adherence with the bundle is associated with better postoperative outcomes, but adherence is lowest in the postoperative period. Identifying risk factors for lower adherence may help design quality improvement strategies. The aim of this study was to estimate the extent to which patient, procedural, and organizational factors predict adherence to postoperative ERP elements in laparoscopic colorectal surgery...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28915206/laparoscopic-colorectal-surgery-in-patients-with-previous-abdominal-surgery-a-single-center-experience-and-literature-review
#4
Erdinc Kamer, Turan Acar, Fevzi Cengiz, Evren Durak, Mehmet Haciyanli
To present the outcomes of laparoscopic colorectal surgery in colorectal cancer patients with a previous history of abdominal surgery. Data of a total of 121 patients with primary colorectal cancer who underwent laparoscopic surgery were retrospectively analyzed. The patients were divided into 2 groups as those with previous abdominal surgery (PAS, n=34) and those without (non-PAS, n=87). Gastric and colonic surgeries were the most common procedures in the major PAS group, whereas gynecologic and obstetric surgeries and appendectomy were the most common procedures in the minor PAS group...
September 14, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28906360/plastic-wound-protectors-decreased-surgical-site-infections-following-laparoscopic-assisted-colectomy-for-colorectal-cancer-a-retrospective-cohort-study
#5
Yang Luo, Yi-Er Qiu, Yi-Fei Mu, Shao-Lan Qin, Yang Qi, Ming Zhong, Min-Hao Yu, Li-Ying Ma
Laparoscopic surgery is widespread and safe for the management of patients with colorectal cancer (CRC). Although the use of standard surgical techniques can prevent perioperative wound infections, surgical site infections (SSIs) remain an unresolved complication in laparoscopic-assisted colectomy. The present study investigated the ability of plastic wound protectors applied to the extraction incision during the externalized portion of the procedure to reduce the rate of infection in laparoscopic-assisted colectomy...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28900886/the-effect-of-obesity-on-laparoscopic-and-robotic-assisted-colorectal-surgery-outcomes-an-acs-nsqip-database-analysis
#6
Jeffrey N Harr, Ivy N Haskins, Richard L Amdur, Samir Agarwal, Vincent Obias
Advantages of robotic-assisted colorectal surgery have been reported, but the effect on outcomes between obese and non-obese patients undergoing laparoscopic and robotic-assisted colorectal surgery remains unclear. Patients who underwent elective laparoscopic and robotic colon or rectal resections between 2012 and 2014 were identified in the ACS-NSQIP database. Propensity score matching was performed to determine the effect of obesity on laparoscopic and robotic-assisted 30-day surgical outcomes. 29,172 patients met inclusion criteria; 27,693 (94...
September 12, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28895143/randomized-clinical-trial-of-laparoscopic-ultrasonography-before-laparoscopic-colorectal-cancer-resection
#7
S B Ellebaek, C W Fristrup, C Hovendal, N Qvist, L Bundgaard, S Salomon, J Støvring, M B Mortensen
BACKGROUND: Intraoperative ultrasonography during open surgery for colorectal cancer may be useful for the detection of unrecognized liver metastases. Laparoscopic ultrasonography (LUS) for the detection of unrecognized liver metastasis has not been studied in a randomized trial. This RCT tested the hypothesis that LUS would change the TNM stage and treatment strategy. METHODS: Patients with colorectal cancer and no known metastases were randomized (1 : 1) to laparoscopic examination (control or laparoscopy plus LUS) in three Danish centres...
October 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28894583/evaluation-of-treatment-for-rectal-neuroendocrine-tumors-sized-under-20-mm-in-comparison-with-the-who-2010-guidelines
#8
Nobuhisa Matsuhashi, Takao Takahashi, Hiroyuki Tomita, Hiroshi Araki, Takashi Ibuka, Kaori Tanaka, Toshiyuki Tanahashi, Satoshi Matsui, Yoshiyuki Sasaki, Yoshihiro Tanaka, Naoki Okumura, Kazuya Yamaguchi, Shinji Osada, Kazuhiro Yoshida
Rectal neuroendocrine tumor (NET) is a relatively rare lesion of the gastrointestinal tract, but the prospective examination with colonofiberoscopy or endoscopic ultrasound has increased the frequency of its detection. It is often difficult to determine the optimal treatment for NETs sized <20 mm in the clinical setting. Other clinicopathological variables are not considered in the current guidelines and staging systems. Although the effects of lymphovascular invasion are not covered by the World Health Organization (WHO) 2010 guidelines or tumor-node-metastasis (TNM) staging system, this may be promising for the establishment of improved guidelines and staging systems, particularly for early-stage colorectal carcinoids...
September 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28890650/economic-impact-of-laparoscopic-conversion-to-open-in-left-colon-resections
#9
Katherine Etter, Brad Davis, Sanjoy Roy, Iftekhar Kalsekar, Andrew Yoo
BACKGROUND AND OBJECTIVES: Studies have shown economic and clinical advantages of laparoscopic left-colon resections. Laparoscopic conversion to open is an important surgical outcome. We estimated conversion incidence, identified risk factors, and measured the clinical and economic impact. METHODS: In this retrospective study, we used the Premier Perspective database to analyze left-sided colectomies from 2009 to 2014. Operating room time (ORT), length of stay (LOS), total hospital cost (2014 U...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28882963/risk-factors-for-transumbilical-wound-complications-in-laparoscopic-gastric-and-colorectal-surgery
#10
Kodai Tomioka, Masahiko Murakami, Akira Fujimori, Makoto Watanabe, Tomotake Koizumi, Satoru Goto, Koji Otsuka, Takeshi Aoki
AIM: To investigate the risk factors of transumbilical incision for organ removal in laparoscopic surgery. PATIENTS AND METHODS: We enrolled 643 consecutive patients undergoing laparoscopic surgery from 2010 to 2013. Superficial surgical site infection (SSI) and transumbilical port site hernia were recorded. RESULTS: The participants underwent gastric (n=253) and colorectal (n=390) resections. SSI was observed in 17 cases (colorectal in 15; gastric in two) (2...
September 2017: In Vivo
https://www.readbyqxmd.com/read/28871343/three-steps-and-a-join-a-simple-guide-to-right-and-left-sided-medial-to-lateral-laparoscopic-colorectal-surgery
#11
M J F X Rickard, A Keshava, J W T Toh
BACKGROUND: To provide a standardised 'medial to lateral' approach to laparoscopic colorectal surgery. METHODS: Both right- and left- sided laparoscopic colorectal procedures were simplified into three well-defined steps and a join. An instructional video and procedural guide provides the important pearls and pitfalls in performing laparoscopic colorectal surgery. RESULTS: During a 10-year period (2006-2016) at a single institution, 20 senior colorectal trainee surgeons and 20 general surgery registrars were trained in the 'three steps and a join' technique...
September 4, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28870951/comparison-of-postoperative-outcomes-between-laparoscopic-and-open-surgery-for-colorectal-cancer
#12
Kai Neki, Ken Eto, Makoto Kosuge, Masahisa Ohkuma, Rota Noaki, Ryosuke Hashizume, Shigemasa Sasaki, Yoshihiro Shirai, Katsuhiko Yanaga
BACKGROUND/AIM: To determine the superiority of the laparoscopic vs. open technique for colorectal cancer surgery. PATIENTS AND METHODS: We performed a retrospective analysis of consecutive patients who underwent curative surgery by laparoscopic colectomy (LC) or open colectomy (OC) for colon cancer. The patients were classified into two groups: as LC group and OC group. We retrospectively assessed clinical characteristics, intraoperative and postoperative outcomes and long-term outcomes between the two groups by univariate analysis...
September 2017: Anticancer Research
https://www.readbyqxmd.com/read/28842796/oncologic-outcomes-following-laparoscopic-colon-cancer-resection-for-t4-lesions-a-case-control-analysis-of-7-years-experience
#13
Piera Leon, Michele Giuseppe Iovino, Fabiola Giudici, Antonio Sciuto, Nicolò de Manzini, Diego Cuccurullo, Francesco Corcione
BACKGROUND: According to many Societies' guidelines, patients presenting with clinical T4 colorectal cancer should conventionally be approached by a laparotomy. Results of emerging series are questioning this attitude. METHODS: We retrospectively analysed the oncologic outcomes of 147 patients operated on between June 2008 and September 2015 for histologically proven pT4 colon cancers. All patients were treated with curative intent, either by a laparoscopic or open "en bloc" resection...
August 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28838869/evolution-of-laparoscopic-liver-surgery-from-innovation-to-implementation-to-mastery-perioperative-and-oncologic-outcomes-of-2-238-patients-from-4-european-specialized-centers
#14
Giammauro Berardi, Stijn Van Cleven, Åsmund Avdem Fretland, Leonid Barkhatov, Mark Halls, Federica Cipriani, Luca Aldrighetti, Mohammed Abu Hilal, Bjørn Edwin, Roberto I Troisi
BACKGROUND: First seen as an innovation for select patients, laparoscopic liver resection (LLR) has evolved since its introduction, resulting in worldwide use. Despite this, it is still limited mainly to referral centers. The aim of this study was to evaluate a large cohort undergoing LLR from 2000 to 2015, focusing on the technical approaches, perioperative and oncologic outcomes, and evolution of practice over time. STUDY DESIGN: The demographics and indications, intraoperative, perioperative, and oncologic outcomes of 2,238 patients were evaluated...
August 31, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28836258/-application-of-transanal-total-mesorectal-excision-in-radical-surgery-for-rectal-cancer
#15
Liu He, Yi Xiao
Transanal total mesorectal excision (taTME) is a novel operative approach of the radical surgery for rectal cancer, and has been a hot topic in colorectal surgery for years. TaTME aims to solve some problems from previous TME, such as exposure of peripheral mid-lower rectal space, judge of distal cutting margin, and to carry out completely minimal invasive operation. According to the degree of completion of different surgical approach, taTME can be divided into laparoscopic assisted taTME (hybrid taTME) and fully through the anal approach to complete the taTME (pure taTME)...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28836249/-comparison-of-intra-abdominal-infection-between-intracorporeal-anastomosis-and-extracorporeal-anastomosis-in-patients-undergoing-laparoscopic-right-hemicolectomy
#16
Xiyu Sun, Huizhong Qiu, Kailun Fei, Lai Xu, Junyang Lu, Guannan Zhang, Yi Xiao
OBJECTIVE: To compare the difference of intra-abdominal infection between intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in patients undergoing laparoscopic right hemicolectomy within postoperative 30 days. METHODS: Clinical date of right colon cancer patients undergoing laparoscopic right hemicolectomy at the Department of Colorectal Surgery, PUMCH from January 1st, 2013 to October 31st, 2016 were retrospectively analyzed. Patients with stage IV cancers which could not be radically resected, emergency operation and conversion to open surgery were excluded...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28836243/-how-to-standardize-transanal-total-mesorectum-excision
#17
Liang Kang
Transanal total mesorectum excision (taTME) is a novel approach to treat rectal cancer by colorectal surgeons. How to standardize taTME is important for colorectal surgeons, especially at their initial attempt. They can start this approach cautiously only after they master skilled laparoscopic technique and pelvic anatomy, get the knowledge of taTME clearly, and are approved by healthcare department. The female patients with age <70 years old, distance of 5 to 7 cm from tumor inferior margin to anal verge, tumor size <3 cm, cTNM stage <T3aN0 are suitable for taTME...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28832924/the-effect-of-acetazolamide-on-intra-ocular-pressure-after-trendelenburg-positioning-a-randomised-double-blind-crossover-trial-in-volunteers
#18
P Vitish-Sharma, A J King, A Abbas, C Maxwell-Armstrong, B Guo, A G Acheson
Recent evidence suggests Trendelenburg positioning can produce a significant rise in intra-ocular pressure. Peri-operative vision loss in patients undergoing laparoscopic colorectal surgery has been reported with the rise in intra-ocular pressure suggested as a possible factor. Acetazolamide decreases intra-ocular pressure by reducing the formation of aqueous humour, so we aimed to investigate if it could attenuate the intra-ocular pressure rise that can occur in the Trendelenburg position. Nine healthy volunteers were recruited and randomly assigned to a double-blind crossover comparison of placebo or acetazolamide with a minimal 4 days' washout period before the second study day...
August 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28827909/laparoscopic-colorectal-surgery-for-cancer-what-is-the-role-of-complete-mesocolic-excision-and-splenic-flexure-mobilization
#19
Rosario Vecchio, Salvatore Marchese, Eva Intagliata
Laparoscopic colorectal surgery for cancer is nowadays routinely performed worldwide. After the introduction by Heald of total mesorectal excision for rectal cancer, also a complete mesocolic excision has been advocated as an essential surgical step to improve oncologic results in patients with colon cancer. The complete removal of mesocolon with high ligation of the main mesenteric arteries and veins and the mobilization of splenic flexure are well-known but still debated in western surgical society. The authors reviewed the literature and outlined the rationale and the results of splenic flexure mobilization and complete mesocolic excision in laparoscopic surgery for colorectal cancer...
August 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28816967/hand-assisted-laparoscopic-surgery-versus-conventional-open-surgery-in-intraoperative-and-postoperative-outcomes-for-colorectal-cancer-an-updated-systematic-review-and-meta-analysis
#20
REVIEW
Xubing Zhang, Qingbin Wu, Chaoyang Gu, Tao Hu, Liang Bi, Ziqiang Wang
AIM: This meta-analysis aims to compare hand-assisted laparoscopic surgery (HALS) and conventional open surgery (OS) for colorectal cancer (CRC) in terms of intraoperative and postoperative outcomes, and to explore the safety, feasibility of HALS for CRC surgery. METHODS: A systematic literature search with no limits was performed in PubMed, Embase, and Medline. The last search was performed on April 23, 2017. The outcomes of interests included intraoperative outcomes (operative time, blood loss, length of incision, transfusion, and lymph nodes harvested), postoperative outcomes (length of hospital stay, length of postoperative hospital stay, time to first flatus, time to first liquid diet, time to first soft diet, time to first bowel movement, postoperative complications, reoperation, ileus, anastomotic leakage, wound infection, urinary complication, pulmonary infection, and mortality)...
August 2017: Medicine (Baltimore)
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