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Feasibility of Hand-Assisted Laparoscopic Surgery as Compared to Open Surgery for Sigmoid Colon Cancer: A Case-Controlled Study

대한대장항문학회지 2013년 29권 1호 p.17 ~ 21
 ( Nam Sang-Eun ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Surgery

 ( Jung Eun-Joo ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Surgery
 ( Paik Jin-Hee ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Surgery
 ( Hwang Dae-Yong ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Surgery
 ( Ryu Chun-Geun ) - Konkuk University School of Medicine Konkuk University Medical Center Department of Surgery

Abstract


Purpose: The aim of this study was to evaluate short-term clinical outcomes by comparing hand-assisted laparoscopic surgery (HALS) with open surgery for sigmoid colon cancer.

Methods: Twenty-six patients who underwent a hand-assisted laparoscopic anterior resection (HAL-AR group) and 52 patients who underwent a conventional open anterior resection during the same period were enrolled (open group) in this study with a case-controlled design.

Results: Pathologic parameters were similar between the two groups. The incidences of immediate postoperative leukocytosis were 38.5% in the HAL-AR group and 69.2% in the open group (P = 0.009). There were no significant differences between the two groups as to leukocyte count, hemoglobin, and hematocrits (P = 0.758, P = 0.383, and P = 0.285, respectively). Of the postoperative recovery indicators, first flatus, sips of water and soft diet started on postoperative days 3, 5, 7 in the HALS group and on days 4, 5, 6 in the open group showed statistical significance (P = 0.021, P = 0.259, and P = 0.174, respectively). Administration of additional pain killers was needed for 1.2 days in the HAL-AR group and 2.4 days in the open group (P = 0.002). No significant differences in the durations of hospital stay and the rates of postoperative complications were noted, and no postoperative mortality was encountered in either group.

Conclusion: The patients with sigmoid colon cancer who underwent a HAL-AR had a lower incidence of postoperative leukocytosis, less administration of pain killers, and faster first flatus than those who underwent open surgery. Clinical outcomes for patients’ recovery and pathology status were similar between the two groups. Therefore, a HAL-AR for sigmoid colon cancer is feasible and has the same benefit as minimally invasive surgery.

키워드

Hand-assisted laparoscopic surgery;Minimally invasive surgery;Anterior resection;Sigmoid colon cancer
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