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

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.

A COMPARATIVE ANALYSIS OF CLINICALAND PATHOLOGICAL OUTCOME FOLLOWING LAPAROSCOPIC VERSUS OPEN RESECTION IN COLORECTAL CANCER IN A TERTIARY CARE CENTRE IN EASTERN INDIA

2021 ◽  
pp. 12-17
Author(s):  
Rishin Dutta ◽  
Makhan Lal Saha ◽  
Chhanda Datta ◽  
Diptendra Kumar Sarkar ◽  
Soumen Das ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Open Surgery ◽  
Tertiary Care ◽  
Operating Time ◽  
Laparoscopic Group ◽  
Open Group ◽  
Tertiary Care Centre ◽  
Colorectal Cancer Surgery ◽  
Female Ratio

Background: Colorectal cancer surgery has undergone a continuous evolution of techniques and technologies with the aim of improving oncological outcome and the quality of life. Methods: Using a computer-based randomization patients were divided into two groups. One group underwent laparoscopic surgery (n=20) while the other open surgery (n=20). Results: rd th th th Most common age group affected was in the 3 and 4 decade of life followed by the 5 and 6 decade with a male: female ratio of 1.1:1. The mean operating time was longer in laparoscopic group (218.0±28 mins vs. 191±25 mins in open group) but the intra-operative blood loss was signicantly less in the laparoscopic group (46.2±8 ml) than the open group (107±11 ml). Post-operative complications like wound infection were signicantly lower in the laparoscopic group (zero patient vs. six patients in open group). Conclusion: With proper training and expertise laparoscopic surgery is advantageous over open surgery in colorectal malignancies.

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.

scholarly journals Improved Oncologic Outcomes Following Laparoscopic Surgery for Small T4 Colon Cancer : A Multi-center Comparative Study

2020 ◽  
Author(s):  
Sung Sil Park ◽  
Joon Sang Lee ◽  
Hyoung-Chul Park ◽  
Sung Chan Park ◽  
Dae Kyung Sohn ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Open Surgery ◽  
Disease Free Survival ◽  
Laparoscopic Group ◽  
Open Group ◽  
Oncologic Outcomes ◽  
Surgery Outcome ◽  
T4 Colon Cancer

Abstract Background: Laparoscopic surgery for T4 colon cancer may be safe in selected patients. Based on the theory that small tumor size might preoperatively predict a good laparoscopic surgery outcome, we herein compare the clinicopathologic and oncologic outcomes of open and laparoscopic 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 cm, who underwent T4 colon cancer surgery between January 2014 and December 2017. We compared the clinicopathologic and 3-year oncologic outcomes between the laparoscopic and open surgery groups.Results: Blood loss, length of hospital stay, and postoperative morbidity were lower in the laparoscopic group than in the open group (86 mL vs. 278 mL, p < 0.001; 10.0 days vs. 12.5 days, p = 0.003; and 18.0% vs. 29.5%, p = 0.005, respectively). There were no intergroup differences in overall survival (OS) and 3-year disease-free survival (DFS; 87.8% vs. 83.2%, p = 0.117; 69.5% vs. 68.1%, p = 0.408, respectively). Among patients with tumors of size ≤4 cm, blood loss was lower in the laparoscopic surgery group than in the open group (80 mL vs. 208 mL, p = 0.001); despite no statistical difference observed in the 3-year OS (84.4% vs 78.7%, p = 0.442), the laparoscopic group had a better 3-year DFS (73.8% vs. 46.0%, p = 0.004).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 small T4 tumors.

scholarly journals Laparoscopic Colorectal Surgery: A Cohort Study in West Sumatera, Indonesia

2017 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Colorectal Surgery ◽  
Hospital Stay ◽  
Open Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Laparoscopic Group ◽  
Open Group ◽  
Surgery Group ◽  
Colon And Rectum ◽  
Surgery Mortality ◽  
Group 1

Background: Traditionally, operation on the colon and rectum required a large abdominal and /or pelvic incision, which often required a lengthy recovery. The introduction of laparoscopic is an example of surgical innovation with a rapid implementation in many areas of surgery. A large number of studies have shown that laparoscopic colorectal surgery is associated with the same benefits than open surgery, including lesser pain, earlier recovery of bowel transit and shorter hospital stay. The use laparoscopic surgery for colorectal cancer still raises a number of concerns, particularly with the technique’s complexity, learning curve and longer duration. Methods: Medical record patients undergoing colorectal surgery were attempted between January 2014 and December 2015. Results: There were 225 patients of which 117 we do laparoscopic and 108 with open technique. Use oral analgetic in laparoscopic group ± 1, 9 (days) and 2, 2 (days) in open group. For hospital stay, 5 days in laparoscopic group and 7 days in open groups. The rate of recurrence was 18 cases (16%) in the laparoscopic group and 28 cases (25%) in the open surgery group. At 2 years after surgery, mortality rate was 19 cases (16%) in laparoscopic group and 27 cases ( 25% ) in open surgery group. 10 cases ( 9%) was cancer-related in laparoscopic group and 21 cases ( 21%) in open group. Conclusion: Proper laparoscopic colorectal surgery is safe and leads to excellent results in terms of recovery and short term outcomes.

Randomized Controlled Trial Comparing Open versus Laparoscopic Placement of a Peritoneal Dialysis Catheter and Outcomes: The Capd I Trial

2017 ◽  
Vol 38 (2) ◽  
pp. 104-112 ◽  
Author(s):  
Jorinde H.H. van Laanen ◽  
Tom Cornelis ◽  
Barend M. Mees ◽  
Elisabeth J. Litjens ◽  
Magda M. van Loon ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Peritoneal Dialysis ◽  
Open Surgery ◽  
Clinical Success ◽  
Controlled Trial ◽  
Laparoscopic Group ◽  
Randomized Controlled ◽  
Surgery Group ◽  
Fixation Techniques ◽  
Open Versus

Objective To determine the best operation technique, open versus laparoscopic, for insertion of a peritoneal dialysis (PD) catheter with regard to clinical success. Clinical success was defined as an adequate function of the catheter 2 – 4 weeks after insertion. Methods All patients with end-stage renal disease who were suitable for PD and gave informed consent were randomized for either open surgery or laparoscopic surgery. A previous laparotomy was not considered an exclusion criterion. Laparoscopic placement had the advantage of pre-peritoneal tunneling, the possibility for adhesiolysis, and placement of the catheter under direct vision. Catheter fixation techniques, omentopexy, or other adjunct procedures were not performed. Other measured parameters were in-hospital morbidity and mortality and post-operative infections. Results Between 2010 and 2016, 95 patients were randomized to this study protocol. After exclusion of 5 patients for various reasons, 44 patients received an open procedure and 46 patients a laparoscopic procedure. Gender, age, body mass index (BMI), hypertension, current hemodialysis, severe heart failure, and previous an abdominal operation were not significantly different between the groups. However, in the open surgery group, fewer patients had a previous median laparotomy compared with the laparoscopic group (6 vs 16 patients; p = 0.027). There was no statistically significant difference in mean operation time (36 ± 24 vs 38 ± 15 minutes) and hospital stay (2.1 ± 2.7 vs 3.1 ± 7.3 days) between the groups. In the open surgery group 77% of the patients had an adequate functioning catheter 2 – 4 weeks after insertion compared with 70% of patients in the laparoscopic group ( p = not significant [NS]). In the open surgery group there was 1 post- operative death (2%) compared with none in the laparoscopic group ( p = NS). The morbidity in both groups was low and not significantly different. In the open surgery group, 2 patients had an exit-site infection and 1 patient had a paramedian wound infection. In the laparoscopic group, 1 patient had a transient cardiac event, 1 patient had intraabdominal bleeding requiring reoperation, and 1 patient had fluid leakage that could be managed conservatively. The survival curve demonstrated a good long-term function of PD. Conclusion This randomized controlled trial (RCT) comparing open vs laparoscopic placement of PD catheters demonstrates equal clinical success rates between the 2 techniques. Advanced laparoscopic techniques such as catheter fixation techniques and omentopexy might further improve clinical outcome.

scholarly journals P336 Minimally invasive surgery is safe and feasible for luminal Crohn’s disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S323-S324
Author(s):  
M Nnaji ◽  
Y F Chin ◽  
O Pujji ◽  
B Wilkinson ◽  
S Mohan ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Minimally Invasive Surgery ◽  
Laparoscopic Surgery ◽  
Crohn's Disease ◽  
Open Surgery ◽  
Surgical Intervention ◽  
Laparoscopic Group ◽  
Readmission Rates ◽  
Inflammatory Bowel ◽  
Reoperation Rates

Abstract Background Crohn’s disease (CD) is an inflammatory bowel condition that still requires surgical intervention in about 70% of cases with laparoscopic surgery increasingly becoming the preferred approach. We present our experience in laparoscopic and open surgery for luminal CD in a DGH setting. Methods This was a retrospective analysis of data collected prospectively between 2008 and 2018. All patients with the diagnosis of CD who underwent a surgical intervention for luminal CD were selected and their demographic, clinical and surgical outcomes data analysed. Results 183 patients were identified. 162 (87%) underwent open and 21 (13%) laparoscopic surgery (p &lt; 0.0001). The median age was 48 years (16–82 years) in the open group and 42 years (16–64 years) in the laparoscopic group(p = 0.05). Male:female ratio was 1:1.2 in the open and 1:1 in the laparoscopic groups. Anastomotic leak rates were lower in the laparoscopic group (0% vs. 2.5%, p = 0.3520). Statistically significant lower readmission rates (9.5% in the laparoscopic, 18% in the open groups, p = 0.0255) and reoperation rates (14% in the laparoscopic and 18% in the open groups, p = 0.0108) were noted in the laparoscopic group. Conclusion Laparoscopic surgery is safe in patients requiring surgical intervention for Crohn’s disease with a notable trend towards improved clinical outcomes.

Laparoscopic Versus Open Appendectomy for the Treatment of Complicated Acute Appendicitis

2020 ◽  
Vol 8 (1) ◽  
pp. 15
Author(s):  
Alireza Barband ◽  
Amir Mangouri ◽  
Changiz Gholipouri ◽  
Abasad Gharedaghi
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Postoperative Pain ◽  
Acute Appendicitis ◽  
Open Surgery ◽  
Surgery Group ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Duration Of Hospitalization ◽  
Complicated Acute Appendicitis

Background and Objective: Acute appendicitis is one of the most common and at the same time lethal if not treated promptly. Failure to treat this medical condition in a timely manner then it can lead to major complications that endanger the patient’s health. In these cases, surgical treatment can be done in an open or laparoscopic method. Despite some limited studies comparing the results of these two therapies, there is still insufficient information in patients with this complicated situation. The aim of this study was to evaluate the results of these two therapies in patients with complicated acute appendicitis. Materials and Methods: In this randomized controlled clinical trial, 52 patients with complicated acute appendicitis in the laparoscopic surgery group and 56 patients in the open surgery group were studied. Primary outcomes in this study were duration of surgery and secondary outcomes including wound infection, intra-abdominal abscess, postoperative pain, miscarriage, hospitalization, and need for re-surgery that were compared between the two groups. Results: Both groups were matched for age (mean 31.0 years in laparoscopic surgery group, 30.5 years in open surgery group, p = 0.81) and gender (28 men in laparoscopic surgery group, 32 men in surgical group, p = 0.73). The mean duration of surgery in the laparoscopic group was significantly longer (mean 66.8 vs. 55.1 min, p <0.001). In contrast, mean duration of hospitalization (85.2 vs 98.6 hours, p <0.001) and mean postoperative pain severity (6.3 vs 7.2, p <0.001) was more significant high in open surgery group. In other cases there was no significant difference between the two groups. Conclusion: Although in surgical treatment of complicated acute appendicitis the duration of laparoscopic surgery is longer than the open method, but the duration of hospitalization and pain intensity in laparoscopic method is significantly reduced.

Laparoscopic Surgery in Patients on Peritoneal Dialysis: A Review of the Literature

2017 ◽  
Vol 24 (4) ◽  
pp. 397-401 ◽  
Author(s):  
Giulio Mari ◽  
Renzo Scanziani ◽  
Sara Auricchio ◽  
Jacopo Crippa ◽  
Dario Maggioni
Keyword(s):  
Peritoneal Dialysis ◽  
Laparoscopic Surgery ◽  
End Stage Renal Disease ◽  
Open Surgery ◽  
Surgical Intervention ◽  
Case Series ◽  
Laparoscopic Technique ◽  
Review Of The Literature ◽  
Stage Renal Disease ◽  
End Stage

Peritoneal dialysis (PD) is an effective renal replacement therapy for the treatment of end-stage renal disease. Patients on PD undergoing abdominal open surgery often fail to resume PD. Laparoscopic surgery has recently become a serious alternative to open surgery in patients on PD to treat different abdominal pathologies. However, only a few studies have reported successful procedures without Tenckhoff catheter removal. The aim of this review is to describe how a laparoscopic technique can allow PD patients to deal with abdominal surgery without shifting to hemodialysis. Only 50 cases of laparoscopic surgical intervention in PD patients have been published to our knowledge. These case series largely concern laparoscopic cholecystectomies, appendectomies, nephrectomies, colectomies, and bariatric procedures. The reported cases show how laparoscopic surgery can be accepted as a valid option for several abdominal surgical procedures in patients on PD with good outcomes and early resumption of PD.

scholarly journals Laparoscopic repair of perforated peptic ulcers without omental patch versus conventional open surgery

2018 ◽  
Vol 5 (3) ◽  
pp. 927
Author(s):  
Vaibhav Srivastava ◽  
Gyanendra Singh ◽  
Santosh K. Singh
Keyword(s):  
Laparoscopic Surgery ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Open Surgery ◽  
Open Repair ◽  
Laparoscopic Group ◽  
Peptic Ulcers ◽  
Omental Patch ◽  
Operative Complications ◽  
Repair Group

Background: Perforation of peptic ulcer usually presents as an acute abdomen. Nearly one third of the patients have no history of the disease. Laparoscopic surgery, a minimally invasive technique, has recently begun to be used on perforated peptic ulcers effectively and frequently. This study aimed to evaluate the efficacy, safety and outcome of laparoscopic surgery without omental patch for perforated ulcers in comparison with conventional open surgery.Methods: All patients diagnosed clinically with perforated peptic ulcers presenting within 24 hours of symptoms and undergoing surgery under a single surgeon during 1-year interval were included in this study and randomly assigned to laparoscopic and open repair group. Patients who had to be converted from laparoscopic surgery to open surgery, were excluded.Results: A total of 69 patients were included in this study. Number of doses of analgesics required in laparoscopic group was 9.48 ± 1.82, while those required in conventional open group was 18.16±2.24. In laparoscopic duodenal perforation repair group, duration of hospital stay (in days) was 8.42±1.44 as compared to 12.08±4.82 in open repair group. Laparoscopic group had significantly fewer post-operative complications but had longer mean operative time (101.90 minutes compared to 60.32 minutes in open repair group).Conclusions: Laparoscopic closure of perforated duodenal ulcer is a simple and safe procedure in experienced hands. It maintains the benefits of the minimally invasive approach. It is associated with longer operating time, less postoperative pain, less post-operative complications, a shorter postoperative hospital stay, and earlier returns to normal daily activities.

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