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The implementation of a standardized approach to laparoscopic rectal surgery

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Authors:
  • Aslak, Katrine Kanstrup ;
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    Gastrounit, Surgical Division, Gastrounit, Amager and Hvidovre Hospital, The Capital Region of Denmark
  • Bulut, Orhan
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    Gastrounit, Surgical Division, Gastrounit, Amager and Hvidovre Hospital, The Capital Region of Denmark
DOI:
10.4293/108680812X13427982376383
Abstract:
BACKGROUND AND OBJECTIVES: The purpose of this study was to audit our results after implementation of a standardized operative approach to laparoscopic surgery for rectal cancer within a fast-track recovery program. METHODS: From January 2009 to February 2011, 100 consecutive patients underwent laparoscopic surgery on an intention-to-treat basis for rectal cancer. The results were retrospectively reviewed from a prospectively collected database. Operative steps and instrumentation for the procedure were standardized. A standard perioperative care plan was used. RESULTS: The following procedures were performed: low anterior resection (n = 26), low anterior resection with loop-ileostomy (n = 39), Hartmann's operation (n = 14), and abdominoperineal resection (n = 21). The median length of hospital stay was 7 days; 9 patients were readmitted There were 9 cases of conversion to open surgery. The overall complication rate was 35%, including 6 cases (90/%) of anastomotic leakages requiring reoperation. The 30-day mortality was 5%. The median number of harvested lymph nodes was 15 (range, 2 to 48). There were 6 cases of positive circumferential resection margins. The median follow-up was 9 (range, 1 to 27) months. One patient with disseminated cancer developed port-site metastasis. CONCLUSIONS: The results confirm the safety of a standardized approach, and the oncological outcomes are comparable to those of similar studies.
Type:
Journal article
Language:
English
Published in:
Journal of the Society of Laparoendoscopic Surgeons, 2012, Vol 16, Issue 2, p. 264-270
Keywords:
Adult; Aged; Aged, 80 and over; Anastomotic Leak; Clinical Audit; Conversion to Open Surgery; Digestive System Surgical Procedures; Female; Humans; Intention to Treat Analysis; Laparoscopy; Male; Middle Aged; Rectal Neoplasms; Treatment Outcome; Journal Article
Main Research Area:
Medical science
Publication Status:
Published
Review type:
Peer Review
Submission year:
2013
Scientific Level:
Scientific
ID:
233812845

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