Introduction. Hand-assisted laparoscopic surgery (HALS) was introduced into
clinical practice in the mid-1990s. Although this technique was established
as a bridge to total laparoscopic colorectal surgery there are still those
who oppose it. In this study we report our 10 year experience of practicing
HALS. Methods. This study is a retrospective analysis of prospectively
collected data of 426 patients undergoing hand-assisted laparoscopic
colorectal surgery for left-sided colon and rectal cancer in a single
tertiary care institution, the National Cancer Institute, from January, 2006,
to July, 2016. All consenting patients with left sided colon and rectal
cancer were included in the analysis. Results. Patient population showed a
similar female and male ratio 212 (49.76%) vs. 214 (50.24%). Average age was
64.13 ? 9.92 years (from 26 to 91). Operation time was 108 minutes ? 44.1 min
(30 - 320 min). The mean length of the postoperative hospital stay was 6.88,
ranging from 2 to 34 days. The pathohistological examination revealed mean
lymph node harvest was 16.4 ? 9.61, ranging from 0 to 54. Stage I and II
cancer prevailed in the majority of cases, accounting for 129 (30.28%) for
each, stage III - 135 (31.69%), and stage IV - 33 (7.74%). Complication rate
was 7.27%. Surgical reintervention was required in 10 cases (2.35%).
Mortality rate occurred only in two (0.47%) patients. Conclusion. In
conclusion, the HALS technique combines the benefits of a minimal invasive
technique for the patient and palpatory benefits for the surgeon, which makes
surgery for left-sided colon and rectum cancer faster, and with a similar
outcome to laparoscopic colectomy.
Hand-assisted laparoscopic surgery for left-sided colon and rectal cancer: 10 Years single centre experience