Effect of Multimodal Opioid-free Anesthesia on Return of Bowel Function in Laparoscopic Colorectal Surgery

Introduction: The article presents early Outcomes in laparoscopic colorectal surgery according to tumour size, duration of surgery, duration of postoperative analgesic requirements, recovery of bowel function, postoperative complications, and mortality. Aim: The aim of the analysis is to describe the short-term outcomes of our patients who endured laparoscopic colonic surgery because of various colon pathologies. Study Design: A Retrospective Case Review cohort study. Methods: The surgical and clinical records of all laparoscopic assisted colon procedures were reviewed and selected for the study held in the Surgical department of Social Security Landhi Hospital Karachi for two years duration from June 2019 to June 2021. All patients underwent surgery under general anaesthesia. Results: During this period, 62 total laparoscopic assisted colon (LAC) procedures were achieved. 41were male and 21 females. 54 patients underwent cancer surgery out of which 51 patient had adenocarcinoma of colon, 2 patient had carcinoids of bowel , and 1 patient had Hodgkin’s lymphoma. Ileocecal tuberculosis was noted in 5 patients and submucosal polyps in one patient. Of these 54 procedures for colonic cancer , 12 were left hemicolectomy, 34 right hemicolectomy, 2 segmental splenic flexure resections, 3 segmental resection with transverse colostomy and 3 sigmoid colectomy The average time of LAC surgery was 140 minutes (range 60 to 250). The average duration of analgesic drugs was 3 days (range 3–6). The median time to the first movement in the bowel was 2.5 days (range 2–4) and the hospital stay was 6 days (range 5–10). Conclusions: Laparoscopically assisted colon procedures are associated with early return of bowel function, less analgesic consumption, short hospital stays, and a lower rate of post operative complication. Laparoscopic colorectal surgery is achievable with optimum operative time and is a logical advantage for good operative outcomes with advanced laparoscopic skills. Keywords: Laparoscopically assisted colon surgery, laparoscopy and Colon cancer.

Download Full-text

Laparoscopic Colorectal Surgery

British Journal of Surgery ◽

10.1046/j.1365-2168.1996.t01-1-00064.x ◽

1996 ◽

Vol 83 (9) ◽

pp. 1307-1307

Author(s):

F. P. McGinn

Keyword(s):

Colorectal Surgery ◽

Laparoscopic Colorectal Surgery

Download Full-text

Faculty Opinions recommendation of Robotic-assisted versus laparoscopic colorectal surgery: a meta-analysis of four randomized controlled trials.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718365131.793523128 ◽

2016 ◽

Author(s):

Scott Steele

Keyword(s):

Colorectal Surgery ◽

Randomized Controlled Trials ◽

Laparoscopic Colorectal Surgery ◽

Meta Analysis ◽

Controlled Trials ◽

Robotic Assisted ◽

Randomized Controlled

Download Full-text

IMPACT OF LAPAROSCOPIC COLORECTAL SURGERY ON BODY IMAGE

British Journal of Surgery ◽

10.1093/bjs/znab160.023 ◽

2021 ◽

Vol 108 (Supplement_3) ◽

Author(s):

A Fernández Candela ◽

L Sánchez-Guillén ◽

L García Catalá ◽

C Curtis Martínez ◽

M Bosch Ramírez ◽

...

Keyword(s):

Body Image ◽

Colorectal Surgery ◽

Laparoscopic Colorectal Surgery ◽

Wound Complication ◽

Descriptive Study ◽

Surgical Quality ◽

Body Image Scale ◽

Study Results ◽

The Impact ◽

Observational Descriptive Study

Abstract INTRODUCTION The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality. MATERIAL AND METHODS We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included. RESULTS The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia). The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression. CONCLUSION Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.

Download Full-text