LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS?
ABSTRACT BACKGROUND: The laparoscopic approach considerably reduced the morbidity of colorectal surgery when compared to the open approach. Among its benefits, we can highlight less intraoperative bleeding, early oral intake, lower rates of surgical site infection, incisional hernia, and postoperat...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgia Digestiva
2024-02-01
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| Series: | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202023000100355&lng=en&tlng=en |
| _version_ | 1797323568092020736 |
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| author | Rodrigo Ambar Pinto Diego Fernandes Maia Soares Lucas Gerbasi Caio Sérgio Rizkallah Nahas Carlos Frederico Sparapan Marques Leonardo Alfonso Bustamante-Lopes Mariane Gouvea Monteiro de Camargo Sérgio Carlos Nahas |
| author_facet | Rodrigo Ambar Pinto Diego Fernandes Maia Soares Lucas Gerbasi Caio Sérgio Rizkallah Nahas Carlos Frederico Sparapan Marques Leonardo Alfonso Bustamante-Lopes Mariane Gouvea Monteiro de Camargo Sérgio Carlos Nahas |
| author_sort | Rodrigo Ambar Pinto |
| collection | DOAJ |
| description | ABSTRACT BACKGROUND: The laparoscopic approach considerably reduced the morbidity of colorectal surgery when compared to the open approach. Among its benefits, we can highlight less intraoperative bleeding, early oral intake, lower rates of surgical site infection, incisional hernia, and postoperative pain, and earlier hospital discharge. AIMS: To compare the perioperative morbidity of right versus left colectomy for cancer and the quality of laparoscopic oncologic resection. METHODS: Retrospective analysis of patients submitted to laparoscopic right and left colctomy between 2006 and 2016. Postoperative complications were classified using the Clavien-Dindo scale, 30 days after surgery. RESULTS: A total of 293 patients were analyzed, 97 right colectomies (33.1%) and 196 left colectomies (66.9%). The averageage was 62.8 years. The groups were comparable in terms of age, comorbidities, body mass index, and the American Society of Anesthesiology (ASA) classification. Preoperative transfusion was higher in the right colectomy group (5.1% versus 0.4%, p=0.004, p<0.05). Overall, 233 patients (79.5%) had no complications. Complications found were grade I and II in 62 patients (21.1%) and grade III to V in 37 (12.6%). Twenty-three patients (7.8%) underwent reoperation. The comparison between left and right colectomy was not statistically different for operative time, conversion, reoperation, severe postoperative complications, and length of stay. The anastomotic leak rate was comparable in both groups(5.6% versus 2.1%, p=0.232, p>0.05). The oncological results were similar in both surgeries. In multiple logistic regression, ASA statistically influenced the worst results (≥ III; p=0.029, p<0.05). CONCLUSIONS: The surgical and oncological results of laparoscopic right and left colectomies are similar, making this the preferred approach for both procedures. |
| first_indexed | 2024-03-08T05:30:28Z |
| format | Article |
| id | doaj.art-f1402a1468d34103b7d6e176ada60171 |
| institution | Directory Open Access Journal |
| issn | 0102-6720 |
| language | English |
| last_indexed | 2024-03-08T05:30:28Z |
| publishDate | 2024-02-01 |
| publisher | Colégio Brasileiro de Cirurgia Digestiva |
| record_format | Article |
| series | ABCD: Arquivos Brasileiros de Cirurgia Digestiva |
| spelling | doaj.art-f1402a1468d34103b7d6e176ada601712024-02-06T07:41:16ZengColégio Brasileiro de Cirurgia DigestivaABCD: Arquivos Brasileiros de Cirurgia Digestiva0102-67202024-02-013610.1590/0102-672020230074e1792LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS?Rodrigo Ambar Pintohttps://orcid.org/0000-0002-6194-0288Diego Fernandes Maia Soareshttps://orcid.org/0000-0002-2286-7866Lucas Gerbasihttps://orcid.org/0000-0003-3351-2590Caio Sérgio Rizkallah Nahashttps://orcid.org/0000-0001-8036-512XCarlos Frederico Sparapan Marqueshttps://orcid.org/0000-0003-4293-6301Leonardo Alfonso Bustamante-Lopeshttps://orcid.org/0000-0002-3159-5858Mariane Gouvea Monteiro de Camargohttps://orcid.org/0000-0002-5906-1663Sérgio Carlos Nahashttps://orcid.org/0000-0002-2268-4146ABSTRACT BACKGROUND: The laparoscopic approach considerably reduced the morbidity of colorectal surgery when compared to the open approach. Among its benefits, we can highlight less intraoperative bleeding, early oral intake, lower rates of surgical site infection, incisional hernia, and postoperative pain, and earlier hospital discharge. AIMS: To compare the perioperative morbidity of right versus left colectomy for cancer and the quality of laparoscopic oncologic resection. METHODS: Retrospective analysis of patients submitted to laparoscopic right and left colctomy between 2006 and 2016. Postoperative complications were classified using the Clavien-Dindo scale, 30 days after surgery. RESULTS: A total of 293 patients were analyzed, 97 right colectomies (33.1%) and 196 left colectomies (66.9%). The averageage was 62.8 years. The groups were comparable in terms of age, comorbidities, body mass index, and the American Society of Anesthesiology (ASA) classification. Preoperative transfusion was higher in the right colectomy group (5.1% versus 0.4%, p=0.004, p<0.05). Overall, 233 patients (79.5%) had no complications. Complications found were grade I and II in 62 patients (21.1%) and grade III to V in 37 (12.6%). Twenty-three patients (7.8%) underwent reoperation. The comparison between left and right colectomy was not statistically different for operative time, conversion, reoperation, severe postoperative complications, and length of stay. The anastomotic leak rate was comparable in both groups(5.6% versus 2.1%, p=0.232, p>0.05). The oncological results were similar in both surgeries. In multiple logistic regression, ASA statistically influenced the worst results (≥ III; p=0.029, p<0.05). CONCLUSIONS: The surgical and oncological results of laparoscopic right and left colectomies are similar, making this the preferred approach for both procedures.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202023000100355&lng=en&tlng=enColorectal SurgeryColectomyIntestinal NeoplasmsMorbidity |
| spellingShingle | Rodrigo Ambar Pinto Diego Fernandes Maia Soares Lucas Gerbasi Caio Sérgio Rizkallah Nahas Carlos Frederico Sparapan Marques Leonardo Alfonso Bustamante-Lopes Mariane Gouvea Monteiro de Camargo Sérgio Carlos Nahas LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS? ABCD: Arquivos Brasileiros de Cirurgia Digestiva Colorectal Surgery Colectomy Intestinal Neoplasms Morbidity |
| title | LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS? |
| title_full | LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS? |
| title_fullStr | LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS? |
| title_full_unstemmed | LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS? |
| title_short | LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS? |
| title_sort | laparoscopic right and left colectomy which provides better postoperative results for oncology patients |
| topic | Colorectal Surgery Colectomy Intestinal Neoplasms Morbidity |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202023000100355&lng=en&tlng=en |
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