EP.FRI.976 ERAS after malignant colorectal resections: A single centre experience

Abstract Aims ERAS employs a multi-modal rehabilitation aids post-op recovery following colorectal resections. ERAS applied in both laparoscopic + open surgery. This study aims to assess effectiveness of ERAS at a single centre. Methods A retrospective study at East Cheshire NHS Trust, since 2008. Descriptive demography & post-operative features were collected for all elective colorectal resections. Results Conclusion ERAS associated with longer operative time (p < 0.05) (laparoscopic surgery), a shorter hospital stay was achieved (p < 0.05). Delayed ERAS occurred in 26.2 % of cases & can result in delayed discharge. Early ERAS deviations occurred in the presence of major surgical complications (ileus, anastomotic leaks, collections). Despite post-operative cardiac & pulmonary events, ERAS was maintained. A targeted rehabilitation programme especially in the elderly patients can lead to earlier recovery.

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Multicenter matched case-control study comparing laparoscopic surgery with open surgery for elderly colon and rectal cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e14091 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e14091-e14091

Author(s):

Yasuo Kawaguchi ◽

Takao Hinoi ◽

Minoru Hattori ◽

Masazumi Okajima ◽

Hideki Ohdan ◽

...

Keyword(s):

Rectal Cancer ◽

Colon Cancer ◽

Laparoscopic Surgery ◽

Elderly Patients ◽

Open Surgery ◽

The Elderly ◽

Colon And Rectal Cancer ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

e14091 Background: Laparoscopic surgery for colon cancer has gained acceptance due to advantages, although no clear equivalent evidences exist for the elderly patients. The aim of this study was to compare outcomes of open and laparoscopic colorectal surgery in patients aged 80 and above, and estimate the feasibility of laparoscopic surgery for the elderly patients. Methods: We conducted a matched case-control study using data from 41 hospitals, the member of Japan Society of Laparoscopic Colorectal Surgery. 2014 patients aged 80 and above underwent surgery for colon or rectal cancer between 2003 and 2007. Propensity score method was used to balance covariates between the surgery groups. Covariates included age, sex, BMI, ASA class, performance status, elective or emergency, previous abdominal surgery, tumor size, tumor site, T-stage, N-stage, and TNM stage. For the prediction model, calibration was assessed by the Hosmer-Lemeshow goodness-of-fit test. The primary end point was overall survival (OS). Secondary end points included disease-free survival (DFS), cancer-specific survival (CSS), and postoperative complications. Results: 1526 and 282 patients underwent surgery for colon and rectal cancer, respectively. The distribution of covariates was significantly different between the open surgery (OP) group and the laparoscopic surgery (LAP) group, in colon and rectal cancer. After propensity score matching, all covariates were balanced and no longer had significant differences, except for tumor size in colon cancer cases. There were 804 patients in 402 pairs managed with the OP or the LAP for colon cancer, and 114 patients in 57 pairs for rectal cancer. OS, DFS and CSS did not differ between the groups for either colon cancer (p = 0.916, 0.968 and 0.799 by log-rank test) or for rectal cancer (p = 0.765, 0.519, and 0.950). Overall morbidities were significantly fewer in the LAP group than in the OP group for colon cancer (24.9% vs. 36.3%, p < 0.001), and no difference for rectal cancer (47.4% vs. 40.4%, p = 0.450). Conclusions: The laparoscopic surgery was not inferior to the open procedure, and can be an acceptable alternative to open surgery for elderly patients with colon and rectal cancer.

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HAND-ASSISTED LAPAROSCOPIC SURGERY FOR THE CANCER OF THE LEFT COLON AND RECTUM - AN IDEAL OPTION OF MINIMALLY INVASIVE SURGERY? SINGLE CENTRE EXPERIENCE WITH 459 CASES

Koloproktologia ◽

10.33878/2073-7556-2017-0-4-7-16 ◽

2017 ◽

pp. 7-16

Author(s):

Narimantas E. Samalavicius ◽

Zygimantas Kuliesius ◽

Audrius Dulskas ◽

Justas Kuliavas ◽

Giedre Rudinskaite ◽

...

Keyword(s):

Rectal Cancer ◽

Laparoscopic Surgery ◽

Minimally Invasive ◽

Open Surgery ◽

Left Colon ◽

Single Centre ◽

Conventional Laparoscopic Surgery ◽

Conventional Laparoscopic ◽

Single Centre Experience ◽

Colon And Rectum

BACKGROUND/OBJECTIVE. Hand-assisted laparoscopic surgery (HALS) has been introduced into clinical practice almost three decades ago, very soon after the introduction of conventional laparoscopic surgery. It combines the advantages of both laparoscopic (minimally invasive) and open surgery. Despite a good piece of data in the medical literature, the clear place of this kind of laparoscopic surgery today is not easy to delineate. Our study aimed to review single centre experience in treating patients with left colon and rectal cancers using HALS. METHODS. This study was a retrospective analysis of prospectively collected data of 459 patients undergoing hand assisted laparoscopic colorectal surgery for left colon and rectal cancer, in a single tertiary care institution, National Cancer Institute, from January 1, 2006, to December 31, 2016. All consented patient with confirmed invasive cancer of left colon and rectum undergoing HALS were included in the analysis. RESULTS. The patients’ mean age was 64.14±9.75 years. Female and male ratio was similar: 232 (50,5 %) versus 227 (49,5 %). The mean length of postoperative hospital stay was 6.7 (from 2 to 34) days. There were 5 (1,1 %) conversions to open surgery. Histological examination revealed mean lymph node harvest to be 15 ± 12, ranging from 8 to 90. Stage I, II and III cancer was similar in distribution accounting for 133 (28,9%), 139 (30,3 %), 151 (32,9 %) patients respectively and 36 (7,8 %)patients with stage IV. 244 (53,2) of patients underwent surgery for the cancer of the left colon (sigmoid colectomy or left hemicolectomy), and 215 (46,8 %) patients underwent surgery for rectal cancer. Postoperative complications occurred in 28 (6.1 %) patients, eight of them (1,7 %) needed reintervention (laparotomy) because of anastomotic insufficiency and intraabdominal abscesses. Two (0,4 %) patients died during 30 day postoperative period. CONCLUSION. In our experience, HALS was very reliable andfeasible minimally invasive surgical technique for the cancers of left colon and rectum, related with short learning curve and excellent oncological clearance, short operating time and low number of postoperative complications. It may be used as a standard approachfor this type of pathology, or as a safe bridge from open to conventional laparoscopic surgery.

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FACTORS INFLUENCING THE OPERATION TECHNIQUE OF PEFORATED DUODENAL ULCER REPAIR BY SINGLEPORT LAPAROSCOPIC SURGERY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2016.4.15 ◽

2016 ◽

pp. 99-105

Author(s):

Huu Tri Nguyen ◽

Loc Le ◽

Doàn Van Phu Nguyen ◽

Nhu Thanh Dang ◽

Thanh Phuc Nguyen

Keyword(s):

Duodenal Ulcer ◽

Laparoscopic Surgery ◽

Correlation Coefficient ◽

Open Surgery ◽

Operative Time ◽

Single Port ◽

Time Correlation ◽

Patch Repair ◽

Perforated Duodenal Ulcer ◽

Conversion To Open Surgery

Background: Single-port laparoscopic surgery (SPLS) is increasingly used in surgery and in the treatment of perforated duodenal ulcer. The aim of this study was to evaluate technical factors for perforated duodenal ulcer repair by SPLS. Methods: A prospective study on 42 consecutive patients diagnosed with perforated duodenal ulcer and treated with SPLS at Hue university of medicine and pharmacy hospital and Hue central hospital from January 2012 to February 2015. Results: The mean age was 48.1 ± 14.2 (17 - 79) years. 40 patients were treated with suture of the perforation by pure SPLS. There was one case (2.4%) in which one additional trocar was required. Conversion to open surgery was necessary in one patient (2.4%) in which the perforation was situated on the posterior duodenal wall. Two patients (4.8%) with history of abdominal surgery were successfully treated by pure SPLS. The size of perforation was correlated with suturing time (correlation coefficient r = 0.459) and operative time (correlation coefficient r = 0.528). Considering suture type, X stitches were used in 95.5% cases, simple stitches were used in one case (2.4%) while Graham patch repair technique was utilized in one case (2.4%) with large perforation. Most cases (95.1%) required only simple suture without omental patch. Peritoneal drainage was spared in most cases (90.2%). Conclusions: SPLS is a safe method for the treatment of perforated duodenal ulcer. Posterior duodenal location is the main cause of conversion to open surgery. Factor related to operative time is perforation size. Key words: perforated duodenal ulcer, single port laparoscopic repair, single port laparoscopy

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Allogeneic Hematopoietic Stem Cell Transplant in Elderly Patients Using Reduce Intensity Conditioning Regimen: A Single Centre Experience

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/j.clml.2017.07.239 ◽

2017 ◽

Vol 17 ◽

pp. S388

Author(s):

Riwa Sakr ◽

Sylvain Pilorge ◽

Stephane Debotton ◽

Claude Chahine ◽

Tereza Coman ◽

...

Keyword(s):

Stem Cell ◽

Elderly Patients ◽

Hematopoietic Stem Cell Transplant ◽

Stem Cell Transplant ◽

Conditioning Regimen ◽

Cell Transplant ◽

Single Centre ◽

Hematopoietic Stem ◽

Reduce Intensity Conditioning ◽

Single Centre Experience

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Retroperitoneal laparoscopic surgery in managing the urinary anormalies in children at Viet Duc Hospital

Vietnam Journal of Endolaparoscopic Surgery ◽

10.51199/vjsel.2019.1.2 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Việt Hoa Nguyễn

Keyword(s):

Laparoscopic Surgery ◽

Retrospective Study ◽

Plastic Surgery ◽

Operative Time ◽

Laparoscopic Approach ◽

Multicystic Dysplastic Kidney ◽

Gender Ratio ◽

Laparoscopic Pyeloplasty ◽

Ureteral Duplication ◽

Dysplastic Kidney

Tóm tắt Đặt vấn đề: Đánh giá kết quả phẫu thuật nội soi sau phúc mạc điều trị bệnh lý thận, tiết niệu ở trẻ em Phương pháp nghiên cứu: Nghiên cứu hồi cứu người bệnh phẫu thuật nội soi sau phúc mạc điều trị bệnh lý thận, tiết niệu trong thời gian từ 1/1/2014 - 31/12/2017. Kết quả: Phẫu thuật nội soi sau phúc mạc cho 110 người bệnh trong đó hẹp khúc nối bể thận - niệu quản là 49 người bệnh (44,54%), thận niệu quản đôi 23 người bệnh (20,91%), thận đa nang 21 người bệnh (19,1%), thận teo mất chức năng 17 người bệnh (15,43%). Tuổi phẫu thuật trung bình là 4,5 ± 3,72 tuổi (từ 1 tuổi- 15 tuổi), tỉ lệ nam/ nữ = 3,3/1. Phẫu thuật nội soi cắt thận cho 52 người bệnh (47,27%), nội soi tạo hình cho 11 người bệnh (10%), nội soi hỗ trợ tạo hình cho 47 người bệnh (42,73%). Thời gian phẫu thuật trung bình 100 ± 20 phút. Thời gian nằm viện sau mổ trung bình là 3 ± 2,3 ngày. Không có biến chứng nặng. Kết quả theo dõi sau mổ 3- 36 tháng cho kết quả tốt 88%, trung bình 10%, xấu 2% Kết luận: Nội soi sau phúc mạc điều trị các bệnh lý thận, tiết niệu ở trẻ em là một phương pháp phẫu thuật an toàn, không có biến chứng, thẩm mỹ và cho kết quả tốt. Abstract Introduction: To evaluate the retroperitoneal laparoscopic surgery in children having the urinary anomalies Material and Methods: Retrospective study for children suffering from urinary anomalies underwent retroperitoneal laparoscopic surgery. Results: 110 children were operated by retroperitoneal laparoscopic approach included: 49 patients (44.54%) with ureter pelvic junction obstruction, 23 patients (20.91%) with ureteral duplication, 21 patients (19.1%) with multicystic dysplastic kidney, 17 patients (15.45%) with atrophy kidney. Mean age was 4.5± 3.72 years old (from 1 year to 15 years old); Gender ratio: male/female = 3.3/1. Laparoscopic nephrectomy for 52 cases (47.27%), 58 cases including 11 cases (10%) retroperitoneal laparoscopic pyeloplasty and 47 cases (42.27%) with assisted laparoscopic plastic surgery. Mean operative time was 100 ± 20 minutes, mean hospitalization length stay was 3 ± 2.3 days. No major complications occurred. Followed from 3 to 36 month are favorable with good outcome in 88%, average in 10%, poor in 2%. Conclusion: Retroperitoneal laparoscopic surgery is safe and feasible procedure in children with urinary anomalies. Keyword: Laparoscopic surgery; Retroperitoneal laparoscopic surgery; Urinary anomalies in children.

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