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Clinical Outcomes of 103 Hand-Assisted Laparoscopic Surgeries for Left-Sided Colon and Rectal Cancer: Single Institutional Review

대한대장항문학회지 2013년 29권 6호 p.225 ~ 230
 ( Samalavicius Narimantas Evaldas ) - Lithuania Faculty of Medicine Family Medicine and Oncology Clinic of Internal

 ( Gupta Rakesh Kumar ) - B.P. Koirala Institute of Health Sciences Gastrointestinal Unit Department of Surgery
 ( Dulskas Audrius ) - Vilnius University Institute of Oncology
 ( Kazanavicius Darius ) - Vilnius University Institute of Oncology
 ( Petrulis Kestutis ) - Vilnius University Institute of Oncology
 ( Lunevicius Raimundas ) - University Hospital Aintree Aintree University Hospitals NHS Foundation Trust


Purpose: The laparoscopic colectomy is avoided principally because of its technical difficulty, steep learning curve, and increased operative time. Hand-assisted laparoscopic surgery (HALS) is an alternative technique that addresses these problems while preserving the short-term benefits of a laparoscopic colectomy. Our study was aimed to describe the characteristics of patients admitted due to left-sided colon and rectal cancer for HALS.

Methods: A prospectively maintained database was used to identify patients who underwent HALS at the Institute of Oncology, Vilnius University, from July 1, 2009, to October 1, 2012.

Results: One hundred-three HALS colorectal resections were performed. The patients’ mean age was 64 ± 13.4 years. There were 46 male and 57 female patients. The body mass index was 27.3 ± 5.8 kg/m2. Forty-three patients (41.8%) had experienced prior abdominal surgery. The mean HALS time was 105 minutes (range, 55-85 minutes). The conversion rate was 2.7% (3/103). The median of return of gastrointestinal function was 2.5 days (range, 2.2-4.5 days). The median length of hospital stay was 9 days. The postoperative complication and mortality rates were 10.7% and 0.97%, respectively. Four incisional hernias (3.9%) were seen at a mean follow-up of 7.0 ± 3.4 months. None of the patients had a trocar or a hand-port site recurrence.

Conclusion: A HALS colorectal resection is a safe and effective technique, and it provides all the benefits of minimally invasive surgery.


Hand-assisted laparoscopy; Laparoscopic colectomy; Short-term outcomes
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