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The implementation of a standardized approach to laparoscopic rectal surgery

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  1. Implementation of a Cross-specialty Training Program in Basic Laparoscopy

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  2. Cost assessment of instruments for single-incision laparoscopic cholecystectomy

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  3. Cystic duct closure by sealing with bipolar electrocoagulation

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  1. Inflammatory response after transanal total mesorectal excision

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  2. Transanal completion proctectomy with close rectal dissection and ileal pouch-anal anastomosis for ulcerative colitis

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Single-incision laparoscopy versus standard laparoscopy for colorectal surgery: A systematic review and meta-analysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Comparison of single-port and conventional laparoscopic abdominoperineal resection

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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.

Original languageEnglish
JournalJournal of the Society of Laparoendoscopic Surgeons
Volume16
Issue number2
Pages (from-to)264-270
Number of pages7
DOIs
Publication statusPublished - 2012

    Research areas

  • 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

ID: 36847760