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Laparoscopic colorectal resection (1996)

Huscher, C. ; Silecchia, G. ; Croce, E. ; [et al.]

Springer

Surgical endoscopy and other interventional techniques 10 (1996), S. 875-879

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ISSN: 1432-2218

Keywords: Key words: Laparoscopic colorectal surgery — Minimally invasive surgery — Colorectal diseases

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract Background. The aim of the present study was to evaluate retrospectively the experience of six surgical units currently performing laparoscopic colorectal surgery. Methods. From November 1991 to January 1994, 200 patients (103 male, 97 female; mean age 62.5 years) were candidates for, and received, laparoscopic colorectal resection for benign (54) or malignant (196) lesions. All the units excluded patients with locally advanced organ tumors and all cases with suspected perforation and ascites. One center submitted to laparoscopic resection only stage I and IV adenocarcinoma. All surgeons considered obesity a relative contraindication. The following data were analyzed: indications, conversion rate to open surgery, operative time, morbidity and mortality, resumption of gastrointestinal function, number of lymph nodes harvested, hospital stay. Results. Twenty-one out of 200 patients were converted to open surgery (10.5%); 37 patients had a complete laparoscopic procedure (17.1%); 137 had an assisted resection (68.5%); and the remaining 5 patients had a facilitated resection. The mean operative time was 208 min (90–480) for assisted resection and 275 min (54–550) for complete laparoscopic resection. The mortality rate was 1.7%; the overall morbidity was 19.6% (major complications 11.2%). All patients quickly became ambulatory and showed a prompt resumption of gastrointestinal functions, and less postoperative pain if compared with converted cases. The average number of lymph nodes was 12.1 (range 1–32). The mean hospital stay was 8.6 days (range 5–14.5). The mean follow-up was 16 months (range 6–24). The recurrence rate 11.7%. Conclusions: Laparoscopy seems to offer the possibility of minimally invasive treatment, but long-term follow-up is needed to evaluate the efficacy of laparoscopic surgery in the treatment of colorectal cancer.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/s004649900187

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Laparoscopic intra-arterial catheter implantation for regional chemotherapy of liver metastasis (1996)

Feliciotti, F. ; Paganini, A. ; Guerrieri, M. ; [et al.]

Springer

Surgical endoscopy and other interventional techniques 10 (1996), S. 449-452

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ISSN: 1432-2218

Keywords: Liver metastasis ; Locoregional chemotherapy ; Port-a-cath ; Laparoscopic surgery ; Laparoscopic intra-arterial catheter implantation

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract In patients with unresectable metastatic disease confined to the liver, intra-arterial regional chemotherapy with implantable systems is an attractive option. Since April 1992, laparoscopic colorectal resections have been performed in our institution. Within this series of patients, three cases with bilateral liver metastasis from colon cancer were observed and underwent laparoscopic intra-arterial catheter implantation in the gastroduodenal artery for regional chemotherapy. In two patients the metastases were synchronous, and in both cases a laparoscopic colon resection was also performed, for tumors located in the cecum and in the sigmoid colon, respectively. The laparoscopic surgical technique for intra-arterial catheter implantation is described in detail. In this limited experience the procedure, from a purely technical point of view, was not considered difficult and was completed in 70 min on average. No complications were observed and the patient with metachronous liver metastasis was discharged on 3rd postoperative day.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00191639

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Single-stage laparoscopic treatment of gallstones and common bile duct stones in 120 unselected, consecutive patients (1995)

Lezoche, E. ; Paganini, A. M.

Springer

Surgical endoscopy and other interventional techniques 9 (1995), S. 1070-1075

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ISSN: 1432-2218

Keywords: Laparoscopic surgery ; Common bile duct stones ; Common bile duct exploration

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract Feasibility, success rate, safety, and shortterm results of single-stage, laparoscopic, transcystic—whenever possible—or choledochotomic treatment of gallstones and common bile duct (CBD) stones were evaluated in 120 unselected patients. Of 1095 patients who underwent laparoscopic cholecystectomy, 120 had ductal stones; among those patients, stones were suspected or proven in 72, 27 of whom were referred after failed endoscopic sphincterotomy (ES) performed elsewhere; unsuspected CBD stones were discovered in 48. The procedure was successful in 116 patients. Four patients required conversion to open surgery. The transcystic access was feasible in 77 patients; a choledochotomy was required in 39. Incidence of retained CBD stones was 4.3%. Minor complications, major complications, and mortality were observed in 6.8%, 1.7%, and 0.8% of patients, respectively. Single-stage laparoscopic treatment of gallstones and CBD stones in unselected patients is safe and feasible in the majority of cases, with success rates and short-term results that are not inferior to reported results of ERCP/ES and cholecystectomy.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00188989

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Technique and results of routine dynamic cholangiography during 528 consecutive laparoscopic cholecystectomies (1994)

Lezoche, E. ; Paganini, A. ; Guerrieri, M. ; [et al.]

Springer

Surgical endoscopy and other interventional techniques 8 (1994), S. 1443-1447

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ISSN: 1432-2218

Keywords: Gallstones ; Laparoscopic cholecystectomy ; Intraoperative cholangiography

Source: Springer Online Journal Archives 1860-2000

Topics: Medicine

Notes: Abstract With the advent of laparoscopic cholecystectomy a trend toward more extensive preoperative diagnostic study of the biliary tree by intravenous cholangiography or ERCP has been observed. However, both exams have technical limitations and are not without risk. We report our experience with 500 consecutive routine dynamic intraoperative cholangiographies during laparoscopic cholecystectomy, 97% of which were successful. No lesions from cholangiography were observed. In ten patients clips on the cystic artery appeared on intraoperative cholangiogram to be too close to the hepatic duct and were removed. Anomalies of surgical importance were discovered in 11 patients (2.3%). Unsuspected stones were found in 18 cases (3.7%) and suspected stones confirmed in 12 (2.4%). In our experience routine dynamic intraoperative cholangiography provided important information in 51 cases out of 500 (10.2%). We conclude that routine dynamic intraoperative cholangiography is extremely useful for safer laparoscopic cholecystectomy and cost containment.

Type of Medium: Electronic Resource

URL: http://dx.doi.org/10.1007/BF00187356

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