Effect of Carbon Nanoparticle Tracer Combined with Laparoscopy in the Treatment of Colon Cancer

2020 ◽  
Vol 20 (10) ◽  
pp. 6007-6012
Author(s):  
Liang Wang ◽  
Huaping Xu ◽  
Xiaofeng Zhang ◽  
Yisheng Zhang ◽  
Lianghui Shi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Recovery Time ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Intraoperative Blood Loss ◽  
Node Dissection ◽  
Surgery Group

In this study, our aim was to compare the clinical effects of laparoscopic surgery and open surgery for the treatment of colon cancer. From January 2018 to December 2018, a random sample of 398 colon cancer patients was collected. The open abdominal surgery group underwent open surgery, while the laparoscopic surgery group underwent laparoscopic surgery. The success rate of the two groups, total intraoperative blood loss, length of incision, postoperative bedtime, times of lymph node dissection, and incidence of postoperative complications were compared. Both groups were provided carbon nanotracers for staining. The intraoperative blood loss of the laparoscopic group was significantly lower than that of the open abdominal group (this difference was statistically significant, P < 0.01). However, the operation time and lymph node dissection were similar for the laparoscopic group and the open abdominal group (the difference was not statistically significant, P > 0.05). The gastrointestinal function recovery time, hospital stay, and lung infection rate of patients in the laparoscopic group were significantly lower than those of patients in the open abdominal group. Postoperative bleeding, anastomotic leakage, and wound infection were also observed, but differences between the groups were not statistically significant. The incidence of postoperative complications in the laparoscopic surgery group was lower than that in the open surgery group (statistically significantly, P < 0.05). Laparoscopic surgery in patients with colon cancer is effective and offers patients improved health, shortened recovery time, and better quality of life. Carbon nanotracers can be used to stain lymph nodes and to make distinguishing between diseased and normal tissue easier.

Assessment of Circumferential Resection Margins (CRM) clearance in Conventional open Versus Laparoscopic Cancer Rectum Resection

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim H Bayan ◽  
Ahmed Abdelaziz ◽  
Tarek Youssef Ahmed ◽  
Mohamed Magdy
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Resection Margins ◽  
Laparoscopy Group ◽  
Surgery Group ◽  
Colon And Rectal Cancer ◽  
Significant Difference

Abstract Background Colon and rectal cancer represent the fourth commonest malignancy worldwide. Globally, colon and rectal cancer make up 9.4% and 10.1% in men and women of all cancers, respectively. Colon and rectal tumors are the third most common malignancy after breast and lung cancer, respectively. The main management of rectal cancer involves a multi-disciplinary team approach and an individually tailored treatment routine. Operative surgery remains the primary and definitive treatment for locally confined rectal adenocarcinoma and is the only historical and current treatment which allows for cure. Resection of the colon and rectal cancer can be done either by open surgical excision or laparoscopically. Aim of the work The objective is to compare the radicality of total mesorectal excision for rectal cancer in both open and laparoscopic surgery through the pathology report. Methods In this multicentric, prospective, comparative study, we included the pathologically established rectal cancer patients from 2 hospitals in Cairo, Egypt, Ain Shams University Hospitals and Maadi Military Hospital, Egypt between 2013 and 2016. The sample size was 40 patients divided into two groups; 20 patients for laparoscopic arm and 20 patients for the open trans-abdominal surgery. Inclusion criteria: histopathology confirmed rectal cancer, patients fit for operative resection, and with T1- T3 grades according to the preoperative evaluation. The exclusion criteria: Patients with T4 stage tumor, patients present as emergency cases and patients present with recurrence of the tumor and synchronous colonic tumors. Results The circumferential resection margins (CRM) of the mesorectum when examined pathologically after resection showed no difference between the two arms of the study with laparoscopic group specimens 3.18±1.16 mm mean, (SD) compared to 3.50±0.45 mm mean, (SD) in the open surgery group with no statistically significant difference. The longitudinal resection margins (LRM) was (5.50±1.98 mean, SD) in the laparoscopic group compared to (5.20±2.28 mean, SD) in the open conventional surgery group with no significant difference found between the two groups. Total operative time was significantly shorter in the trans-abdominal surgery group, while the hospital stay period was significantly shorter in the laparoscopy group. Laparoscopy group also showed significantly time before flatus passage, and the patients in the laparoscopy group started oral intake faster than open surgery group. Conclusion In our study, the radicality of the rectal cancer excision in both laparoscopic and traditional open surgery, showed non inferiority of the laparoscopic technique over open surgery Long-term clinical outcomes of overall survival and recurrence is the foremost parameters which should be taken in consideration for decision for laparoscopic surgery for rectal cancer. Additional follow-up results from the current trial are presently being developed, beside with records on other secondary end points, like cost effectiveness and quality of life.

scholarly journals Laparoscopic surgery for colorectal cancer with persistent descending mesocolon

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Yukiharu Hiyoshi ◽  
Yuji Miyamoto ◽  
Kojiro Eto ◽  
Yohei Nagai ◽  
Masaaki Iwatsuki ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Blood Flow ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Sigmoid Colon ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Marginal Artery ◽  
Ir Imaging

Abstract Background Persistent descending mesocolon (PDM) is caused by the absence of fusion of the descending colon to the retroperitoneum. We herein report two colorectal cancer cases with PDM that were treated with laparoscopic surgery. Case presentation Case 1: a 50-year-old man with sigmoid colon cancer and synchronous liver metastasis. After neoadjuvant chemotherapy, he underwent laparoscopic sigmoidectomy with lymph node dissection cutting the root of the inferior mesenteric artery (IMA) and synchronous liver resection. He experienced postoperative stenosis of the reconstructed colon possibly due to an impaired arterial blood flow in the reconstructed colon. Case 2: a 77-year-old man with rectal cancer. Laparoscopic low anterior resection preserving the left colic artery (LCA) was performed. Intraoperative infrared ray (IR) imaging using indocyanine green (ICG) showed good blood flow of the reconstructed colon. He had no postoperative complications. In cases of PDM, the mesentery of the descending and sigmoid colon containing the LCA is often shortened, and the marginal artery of the reconstructed colon is located close to the root of the LCA. Lymph node dissection accompanied by cutting the LCA carries a risk of marginal artery injury. Therefore, we recommend lymph node dissection preserving the LCA in colorectal cancer patients with PDM in order to maintain the blood flow of the reconstructed colon. If the IMA and LCA absolutely need to be cut for complete lymph node dissection, the marginal artery should be clearly identified and preserved. In addition, intraoperative IR imaging is extremely useful for evaluating colonic perfusion and reducing the risk of anastomotic complications. Conclusion In colorectal cancer surgery in patients with PDM, surgeons should be aware of these tips for maintaining the blood flow of the reconstructed colon and thereby avoid postoperative complications caused by an impaired blood flow.

Risk factors for postoperative complications of a randomized clinical trial: Laparoscopic versus open surgery with D3 lymphadenectomy for stage II/III colon cancer (JCOG0404).

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 717-717
Author(s):  
Yusuke Nishizawa ◽  
Masaaki Ito ◽  
Norio Saito ◽  
Hiroshi Katayama ◽  
Junki Mizusawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Trial ◽  
Colon Cancer ◽  
Multivariate Analysis ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Open Surgery ◽  
Clinical Stage ◽  
Stage Ii ◽  
Colon Cancers

717 Background: A randomized controlled trial to confirm the non-inferiority of laparoscopic surgery to open surgery for clinical stage II/III colon cancers in terms of overall survival was conducted. In this ancillary study, we explored the risk factors for postoperative complications of laparoscopic surgery and open surgery. Methods: Eligibility criteria included colon cancer; tumor located in the cecum, ascending, sigmoid, or rectosigmoid colon; T3 or T4 without involvement of other organs; N0-2; and M0. Postoperative complications which were observed from the end of the operation to discharge were graded according to the CTCAE 3.0. Multivariate analysis was performed using logistic regression model. Results: Between October 2004 and March 2009, a total of 1,057 patients from 30 Japanese centers were registered. By per-protocol set, 524 patients underwent open surgery (OPEN) and 533 patients underwent laparoscopic surgery (LAP). Proportion of any grade (G) complication was 18.3% (OPEN 22.3%, LAP 14.3%), G2–G3 was 12.9% (OPEN 13.9%, LAP 11.8%), G3 was 5.3% (OPEN 6.9%, LAP 3.8%) and G4 was none. Postoperative complications (G2-G3) included leakage (OPEN 2.1%, LAP 1.9%), ileus (OPEN:1.5%, LAP:0.9%), and wound complication (OPEN: 0.2%, LAP: none). Multivariate analysis revealed that risk factors for postoperative complications were operation times 240 min or more (p=0.0019, odds ratio [OR] 2.01 [95% CI: 1.30-3.13]) and open surgery (p=0.0001, OR 2.05 [95% CI: 1.41-2.98]). Conclusions: Operation times more than 240 min and open surgery were considered to be the risk factors for postoperative complications for clinical stage II/III colon cancers. Clinical trial information: C000000105.

scholarly journals Favorable short-term oncologic outcomes following laparoscopic surgery for small T4 colon cancer: a multicenter comparative study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Sung Sil Park ◽  
◽  
Joon Sang Lee ◽  
Hyoung-Chul Park ◽  
Sung Chan Park ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Open Surgery ◽  
Disease Free Survival ◽  
Laparoscopic Group ◽  
Oncologic Outcomes ◽  
Short Term ◽  
Free Survival ◽  
T4 Colon Cancer ◽  
Disease Free

Abstract Background Laparoscopic surgery for T4 colon cancer may be safe in selected patients. We hypothesized that small tumor size might preoperatively predict a good laparoscopic surgery outcome. Herein, we compared the clinicopathologic and oncologic outcomes of laparoscopic and open surgery in small T4 colon cancer. Methods In a retrospective multicenter study, we reviewed the data of 449 patients, including 117 patients with tumors ≤ 4.0 cm who underwent surgery for T4 colon cancer between January 2014 and December 2017. We compared the clinicopathologic and 3-year oncologic outcomes between the laparoscopic and open groups. Survival curves were estimated using the Kaplan–Meier method and compared using the log-rank test. Univariate and multivariate analyses were performed using the Cox proportional hazards model. A p < 0.05 was considered statistically significant. Results Blood loss, length of hospital stay, and postoperative morbidity were lower in the laparoscopic group than in the open group (median [range], 50 [0–700] vs. 100 [0–4000] mL, p < 0.001; 8 vs. 10 days, p < 0.001; and 18.0 vs. 29.5%, p = 0.005, respectively). There were no intergroup differences in 3-year overall survival or disease-free survival (86.6 vs. 83.2%, p = 0.180, and 71.7 vs. 75.1%, p = 0.720, respectively). Among patients with tumor size ≤ 4.0 cm, blood loss was significantly lower in the laparoscopic group than in the open group (median [range], 50 [0–530] vs. 50 [0–1000] mL, p = 0.003). Despite no statistical difference observed in the 3-year overall survival rate (83.3 vs. 78.7%, p = 0.538), the laparoscopic group had a significantly higher 3-year disease-free survival rate (79.2 vs. 53.2%, p = 0.012). Conclusions Laparoscopic surgery showed similar outcomes to open surgery in T4 colon cancer patients and may have favorable short-term oncologic outcomes in patients with tumors ≤ 4.0 cm.

scholarly journals Open versus Laparoscopic Inguinal Hernioplasty - Outcome Correlation

2017 ◽  
Vol 8 (1) ◽  
pp. 3-7
Author(s):  
Akhter Ahmed ◽  
Salma Yesmin Chowdhury ◽  
Md Mustafizur Rahman ◽  
Farhana Shimu ◽  
Shaon Shahriar ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Confidence Interval ◽  
Mesh Repair ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Open Group ◽  
Laparoscopic Technique ◽  
Percent Confidence Interval ◽  
Surgery Group ◽  
Inguinal Hernias

Background: Repair of inguinal hernias in men is a common surgical procedure, but the most effective surgical technique is still in debate.Methods: We randomly assigned men with inguinal hernias at Mitford Hospital surgery, ward to either open mesh or laparoscopic mesh repair. The primary aim was to detect recurrence of hernias in both groups at 6 month. Secondary aims were to detect complications and patient compliance.Results: of the 70 patients who were randomly assigned to one of the two procedures, 62 underwent operation; 6 month follow-up was completed in 55 (78.6%). Recurrences were only one in the laparoscopic group (3.6%) and 1 in the open group (3.7%). The rate of complications was lower in the laparoscopic-surgery group than in the open-surgery group (17.6% vs. 27%). The laparoscopic- surgery group had less pain initially than the open-surgery group on the day of surgery (difference in mean score on a visual-analogue scale, 10.2 mm; 95 percent confidence interval, 4.8 to 15.6) and at two weeks (6.1 mm; 95 percent confidence interval, 1.7 to 10.5) and returned to normal activities earlier (adjusted hazard ratio for a shorter time to return to normal activities, 1.2; 95% confidence interval, 1.1 to 1.3). Hospital stay was shorter in laparoscopic group (2.6 days vs 3.2 days). Patients’ satisfaction with surgery was 95% in the laparoscopic group and 87% in open group. Nenety six laparoscopic and 87% of open surgery patients perceived that they were healthy after surgery. Total treatment cost was more in laparoscopic group.Conclusions: The laparoscopic technique is superior to the open technique for mesh repair of primary hernias.J Shaheed Suhrawardy Med Coll, June 2016, Vol.8(1); 3-7

scholarly journals Preoperative Assessment of Vascular Anatomy by Multidetector Computed Tomography Before Laparoscopic Colectomy for Transverse Colon Cancer: Report of a Case

2015 ◽  
Vol 100 (2) ◽  
pp. 208-212 ◽  
Author(s):  
Aya Kawamoto ◽  
Yasuhiro Inoue ◽  
Masato Okigami ◽  
Hiromi Yasuda ◽  
Yoshinaga Okugawa ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Colon Cancer ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Lymph Node Dissection ◽  
Transverse Colon ◽  
Vascular Anatomy ◽  
Preoperative Assessment ◽  
Transverse Colon Cancer ◽  
Node Dissection

Although the safety of laparoscopic surgery for colon cancer has been reported in many randomized controlled trials, concerns about the difficulty of surgery for transverse colon cancer has not been fully resolved, mainly because of the variation in the vascular anatomy of mesenteric vessels, which leads to difficulty in determining the optimal operative procedure and the extent of lymph node dissection. We present the case of a patient with transverse colon cancer who underwent laparoscopic surgery after preoperative assessment using a combination of endoscopic clipping and three-dimensional computed tomography angiography (3DCTA). A 68-year-old man was diagnosed with transverse colon cancer, and laparoscopic surgery has been planned. 3DCTA showed right-middle and left-middle colic arteries arising independently from the superior mesenteric artery. The relationship between the clip and vessels showed that the right-middle colic artery was the feeding artery of the tumor. Operative findings were consistent with 3DCTA findings, and transverse colectomy with lymph node dissection was successfully performed.

scholarly journals Laparoscopic procedure is associated with lower morbidity for simultaneous resection of colorectal cancer and liver metastases: an updated meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Long Pan ◽  
Chenhao Tong ◽  
Siyuan Fu ◽  
Jing Fang ◽  
Qiuxia Gu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Meta Analysis ◽  
Effective Length ◽  
Cochrane Library ◽  
Intraoperative Blood Loss ◽  
Surgery Group ◽  
Simultaneous Resection

Abstract Background It has been demonstrated that simultaneous resection of both primary colorectal lesion and metastatic hepatic lesion is a safe approach with low mortality and postoperative complication rates. However, there are some controversies over which kind of surgical approach is better. The aim of study was to compare the efficacy and safety of laparoscopic surgeries and open surgeries for simultaneous resection of colorectal cancer (CRC) and synchronous colorectal liver metastasis (SCRLM). Methods A systemic search of online database including PubMed, Web of Science, Cochrane Library, and Embase was performed until June 5, 2019. Intraoperative complications, postoperative complications, and long-term outcomes were synthesized by using STATA, version 15.0. Cumulative and single-arm meta-analyses were also conducted. Results It contained twelve studies with 616 patients (273 vs 343, laparoscopic surgery group and open surgery group, respectively) and manifested latest surgical results for the treatment of CRC and SCRLM. Among patients who underwent laparoscopic surgeries, they had lower rates of postoperative complications (OR = 0.66, 95% CI: 0.46 to 0.96, P = 0.028), less intraoperative blood loss (weight mean difference (WMD) = − 113.31, 95% CI: − 189.03 to − 37.59, P = 0.003), less time in the hospital and recovering after surgeries (WMD = − 2.70, 95% CI: − 3.99 to − 1.40, P = 0.000; WMD = − 3.20, 95% CI: − 5.06 to − 1.34, P = 0.001), but more operating time (WMD = 36.57, 95% CI: 7.80 to 65.35, P = 0.013). Additionally, there were no statistical significance between two kinds of surgical approaches in disease-free survival and overall survival. Moreover, cumulative meta-analysis indicated statistical difference in favor of laparoscopic surgery in terms of morbidity was firstly detected in the 12th study in 2018 (OR = 0.66, 95% CI: 0.46 to 0.96, P = 0.028) as the 95% CI narrowed. Conclusion Compared with open surgeries, laparoscopic surgeries are safer (postoperative complications and intraoperative blood loss) and more effective (length of hospital stay and postoperative stay), and it can be considered as the first option for management of SCRLM in high-volume laparoscopic centers. Trial registration CRD42020151176

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