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Comparison and short-term outcomes between hand-assisted laparoscopic surgery and conventional laparoscopic surgery for anterior resections of left-sided colon cancer

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Abstract

Background

Hand-assisted laparoscopic surgery has been introduced as an alternative to conventional laparoscopic surgery. This study compared the efficacies and short-term clinical outcomes between hand-assisted laparoscopic anterior resection (HAL-AR) and conventional laparoscopic anterior resection (CL-AR) for treating left-sided colon cancer.

Materials and methods

We retrospectively analyzed 248 patients who underwent anterior resection for colon cancer (118 HAL-AR and 128 CL-AR) between May 2000 and December 2006. The collected data included the perioperative and short-term oncologic outcomes.

Results

There were no significant differences between the HAL-AR and CL-AR groups, except for the operation time and the size of the primary tumor. The operation time of the HAL-AR group was significantly shorter than that of the CL-AR group (p = 0.004), and the size of the primary tumor in the HAL-AR group was significantly larger than that of the CL-AR group (p = 0.019). The operating time of the HAL-AR group reached an earlier mean plateau than did that of the CL-AR group. Before and after reaching the plateau, there were no differences in the perioperative results between the two groups. The operating time for the HAL-AR group was significantly shorter than that of the CL-AR group after reaching a plateau (p = 0.012). The short-term outcomes for both groups were similar in terms of survival and recurrence (p = 0.996 and p = 0.476, respectively).

Conclusion

Hand-assisted laparoscopic anterior resection has a shorter operative time than does CL-AR and is more successful than CL-AR for resecting larger tumors, while both procedures result in similar short-term oncologic outcomes. Hand-assisted laparoscopic anterior resection is thought be a comparable operative technique for anterior resection of left-sided colon cancer.

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References

  1. The Southern Surgeons Club (1991) A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 324:1073–1078

    Google Scholar 

  2. Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H (2007) Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg 246:655–662, discussion 662–654

    Article  PubMed  Google Scholar 

  3. Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059

    Article  Google Scholar 

  4. Cuschieri A, Shapiro S (1995) Extracorporeal pneumoperitoneum access bubble for endoscopic surgery. Am J Surg 170:391–394

    Article  CAS  PubMed  Google Scholar 

  5. Nakajima K, Lee SW, Cocilovo C, Foglia C, Sonoda T, Milsom JW (2004) Laparoscopic total colectomy: hand-assisted vs standard technique. Surg Endosc 18:582–586

    Article  CAS  PubMed  Google Scholar 

  6. HALS Study Group (2000) Hand-assisted laparoscopic surgery vs standard laparoscopic surgery for colorectal disease: a prospective randomized trial. Surg Endosc 14:896–901

    Article  Google Scholar 

  7. Clavien PA, Sanabria JR, Strasberg SM (1992) Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery 111:518–526

    CAS  PubMed  Google Scholar 

  8. Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiger E, Elson P (1998) A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 187:46–54, discussion 54–45

    Article  CAS  PubMed  Google Scholar 

  9. Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G (2002) Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA 287:321–328

    Article  PubMed  Google Scholar 

  10. Nelson H, Weeks JC, Wieand HS (1995) Proposed phase III trial comparing laparoscopic-assisted colectomy versus open colectomy for colon cancer. J Natl Cancer Inst Monogr 19:51–56

    PubMed  Google Scholar 

  11. Reissman P, Cohen S, Weiss EG, Wexner SD (1996) Laparoscopic colorectal surgery: ascending the learning curve. World J Surg 20:277–281, discussion 282

    Article  CAS  PubMed  Google Scholar 

  12. Cobb WS, Lokey JS, Schwab DP, Crockett JA, Rex JC, Robbins JA (2003) Hand-assisted laparoscopic colectomy: a single-institution experience. Am Surg 69:578–580

    PubMed  Google Scholar 

  13. Hassan I, You YN, Cima RR, Larson DW, Dozois EJ, Barnes SA, Pemberton JH (2008) Hand-assisted versus laparoscopic-assisted colorectal surgery: practice patterns and clinical outcomes in a minimally-invasive colorectal practice. Surg Endosc 22:739–743

    Article  PubMed  Google Scholar 

  14. Lee SW, Yoo J, Dujovny N, Sonoda T, Milsom JW (2006) Laparoscopic vs. hand-assisted laparoscopic sigmoidectomy for diverticulitis. Dis Colon Rectum 49:464–469

    Article  PubMed  Google Scholar 

  15. Chang YJ, Marcello PW, Rusin LC, Roberts PL, Schoetz DJ (2005) Hand-assisted laparoscopic sigmoid colectomy: helping hand or hindrance? Surg Endosc 19:656–661

    Article  PubMed  Google Scholar 

  16. Ringley C, Lee YK, Iqbal A, Bocharev V, Sasson A, McBride CL, Thompson JS, Vitamvas ML, Oleynikov D (2007) Comparison of conventional laparoscopic and hand-assisted oncologic segmental colonic resection. Surg Endosc 21:2137–2141

    Article  CAS  PubMed  Google Scholar 

  17. Targarona EM, Gracia E, Garriga J, Martinez-Bru C, Cortes M, Boluda R, Lerma L, Trias M (2002) Prospective randomized trial comparing conventional laparoscopic colectomy with hand-assisted laparoscopic colectomy: applicability, immediate clinical outcome, inflammatory response, and cost. Surg Endosc 16:234–239

    Article  CAS  PubMed  Google Scholar 

  18. Tjandra JJ, Chan MK, Yeh CH (2008) Laparoscopic- vs. hand-assisted ultralow anterior resection: a prospective study. Dis Colon Rectum 51:26–31

    Article  PubMed  Google Scholar 

  19. Chung CC, Ng DC, Tsang WW, Tang WL, Yau KK, Cheung HY, Wong JC, Li MK (2007) Hand-assisted laparoscopic versus open right colectomy: a randomized controlled trial. Ann Surg 246:728–733

    Article  PubMed  Google Scholar 

  20. LW YHR, Chun HK et al (2007) Learning curve for laparoscopic colorectal surgery: hand assisted laparoscopic surgery (HALS) versus conventional laparoscopic surgery (CLS). J Korean Soc Coloproctol 23:161–166

    Article  Google Scholar 

  21. Cuschieri A, Frank TG, Brown S, Martin D, Gove JL (2003) A new multitool for hand-assisted advanced laparoscopic surgery (HALS). Surg Endosc 17:1368–1371

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Ho-Kyung Chun.

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Yun, H.R., Cho, Y.K., Cho, Y.B. et al. Comparison and short-term outcomes between hand-assisted laparoscopic surgery and conventional laparoscopic surgery for anterior resections of left-sided colon cancer. Int J Colorectal Dis 25, 975–981 (2010). https://doi.org/10.1007/s00384-010-0948-z

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  • DOI: https://doi.org/10.1007/s00384-010-0948-z

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