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A Short-term Clinical Analysis of Hand-assisted Laparoscopic Colorectal Surgery Versus Open Colorectal Surgery

Author: ShangLiang
Tutor: LiLePing
School: Shandong University
Course: Surgery
Keywords: Hand-assisted Laparoscopic Surgery (HALS) Colorectal Surgery Colorectal Cancer Open Surgery
CLC: R656.9
Type: Master's thesis
Year: 2012
Downloads: 53
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Objectives:To discuss and summarize the short-term effect and clinical significance of hand-assisted laparoscopic surgery (HALS) with colorectal carcinoma patients.Methods:A retrospective study analyses short-term effect of hand-assisted laparoscopic colorectal surgery (HALC) and open colorectal surgery (OC) including62patients in HALC group and67patients in OC group. The two groups were main compared in incision length, operative time, estimated blood loss, tumor size, number of lymph nodes, bowel function recovery time, postoperative complications, length of hospital stay and recurrence. We used Pearson’s chi-square and two-sample t-tests to compare the differences in demographics and perioperative parameters in statistical analysis.Results:There were no significant differences in age, gender distribution, body mass index (BMI), American Society of Anesthesiologists (ASA) scores, comorbidity, or history of abdominal surgery;The HALC group was significantly better than OC group not only in incision length (7.06±1.69cm vs16.13±1.46cm),but also in estimated blood loss (43.9±23.9ml vs102.8±39.5ml). There was no significant difference in operative time, HALC group was (135.2±22.1) min and the open group was (129.7±29.3) min. HALC group in terms of tumor size (3.67±1.66cm) and number of lymph nodes (15.76±4.1) can be same as OC group which got (3.90±1.45cm) and (14.79±4.79). Postoperative pathologic stage were no obvious difference in the two groups.For the postoperative recovery, HALC group showed significantly better than OC group in bowel function recovery time (2.85±0.65d vs3.45±0.74d) and the length of hospital stay (8.24±1.93d vs9.84±1.68d).What’s more, HALC group had less postoperative complications than OC group (9.7%vs17.9%). All patients were followed up for up to18months, minimum of2months, in the OC group1patient were followed up9months later died of tumor recurrence, MODS, and the remaining cases were no recurrence and death.Conclusion:Compared with open surgery, hand-assisted laparoscopic surgery offers less trauma, faster recovery, fewer complications and shorter hospital stay and so on. And in the tumor and lymph node dissection aspects, HALS can achieve the same effect with open colorectal surgery. HALS combines the advantages of both laparoscopic (minimally invasive) and conventional open surgery. It is safe and feasible in malignant colorectal tumors.

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