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Surgical Endoscopy
Published in: Surgical Endoscopy 9/2006

01-09-2006

Reduction of prolonged postoperative hospital stay after laparoscopic surgery for colorectal carcinoma

Authors: S. Yamamoto, S. Fujita, T. Akasu, K. Uehara, Y. Moriya

Published in: Surgical Endoscopy | Issue 9/2006

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Abstract

Background

In evaluating the quality of laparoscopic surgery (LS) for colorectal carcinoma, many previous reports have used median or range values to assess the length of postoperative hospital stay and to show the complication and conversion rates separately. However, with this method, it is impossible to assess the proportion of patients who required prolonged postoperative hospital stay because of perioperative morbidities. This study investigated the proportion of patients who benefited from LS as minimally invasive surgery by assessing the percentage of patients who required prolonged postoperative hospital stay because of major perioperative morbidities.

Methods

A review of 202 patients who underwent LS for colorectal carcinoma at the authors’ hospital between January 2002 and December 2004 was performed. Short-term outcomes were compared among the patients who underwent LS in 2002, 2003, and 2004.

Results

No significant differences were observed in baseline characteristics among the groups, and all the procedures in this study were completed laparoscopically. There were no significant differences in the operative times and intraoperative blood losses among the groups. Most of the patients resumed liquid intake on postoperative day 1 and solid food on day 3. However, there was a significant difference in the rate of postoperative prolonged hospital stays by year of surgery. In 2004, 97.3% of the patients (72/74) undergoing LS could be discharged to home within 8 days postoperatively. Major complications occurred at a low rate of 1.4% (1/74) in 2004. Regarding the reasons for prolonged postoperative hospital stay, inappropriate judgment of the physician in charge, based primarily on requests from patients without medical necessity, disappeared in 2004.

Conclusions

When LS is performed properly by specialists who have accumulated sufficient experience in both LS and conventional open surgery for colorectal carcinoma, up to 97% of patients undergoing LS can benefit from minimally invasive surgery.
Literature
1.
Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91: 1111–1124PubMedCrossRef
2.
Anthuber M, Fuerst A, Elser F, Berger R, Jauch KW (2003) Outcome of laparoscopic surgery for rectal cancer in 101 patients. Dis Colon Rectum 46: 1047–1053PubMedCrossRef
3.
Bärlehner E, Benhidjeb T, Anders S, Schicke B (2005) Laparoscopic resection for rectal cancer: outcomes in 194 patients and review of the literature. Surg Endosc 19: 757–766PubMedCrossRef
4.
Branagan G, Finnis D (2005) Prognosis after anastomotic leakage in colorectal surgery. Dis Colon Rectum 48: 1021–1026PubMedCrossRef
5.
Bretagnol F, Lelong B, Laurent C, Moutardier V, Rullier A, Monges G, Delpero JR, Rullier E (2005) The oncological safety of laparoscopic total mesorectal excision with sphincter preservation for rectal carcinoma. Surg Endosc 19: 892–896PubMedCrossRef
6.
Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350: 2050–2059CrossRef
7.
COLOR Study Group (2005) Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer. Surg Endosc 19: 687–692CrossRef
8.
Delgado S, Momblán D, Salvador L, Bravo R, Castells A, Ibarzabal A, Piqué JM, Lacy AM (2004) Laparoscopic-assisted approach in rectal cancer patients: lessons learned from > 200 patients. Surg Endosc 18: 1457–1462PubMedCrossRef
9.
Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AMH, Heath RM, Brown JM, MRC CLASICC Trial Group (2005) Short-term end points of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomized, controlled trial. Lancet 365: 1718–1726PubMedCrossRef
10.
Hasegawa H, Kabeshima Y, Watanabe M, Yamamoto S, Kitajima M (2003) Randomized controlled trial of laparoscopic versus open colectomy for advanced colorectal cancer. Surg Endosc 17: 636–640PubMedCrossRef
11.
Kitano S, Inomata M, Sato A, Yoshimura K, Moriya Y, Colorectal Cancer Study Group (CCSG) of Japan Clinical Oncology Group (2005) Randomized controlled trial to evaluate laparoscopic surgery for colorectal cancer: Japan Clinical Oncology Group study JCOG 0404. Jpn J Clin Oncol 35: 475–477PubMedCrossRef
12.
Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, Visa J (2002) Laparoscopic-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet 359: 2224–2229PubMedCrossRef
13.
Leroy J, Jamali F, Forbes L, Smith M, Rubino F, Mutter D, Marescaux J (2004) Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes. Surg Endosc 18: 281–289PubMedCrossRef
14.
Leung KL, Kwok SPY, Lam SCW, Lee JFY, Yiu RYC, Ng SSM, Lai PBS, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363: 1187–1192PubMedCrossRef
15.
Leung KL, Lai PBS, Ho RLK, Meng WCS, Yiu RYC, Lee JFY, Lau WY (2000) Systemic cytokine response after laparoscopic-assisted resection of rectosigmoid carcinoma: a prospective randomized trial. Ann Surg 231: 506–511PubMedCrossRef
16.
Milsom JW, Böhm B, Hammerhofer KA, Fazio V, Steiger E, Elson P (1998) A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. Am Coll Surg 187: 46–57CrossRef
17.
Nishiguchi K, Okuda J, Toyoda M, Tanaka K, Tanigawa N (2001) Comparative evaluation of surgical stress of laparoscopic and open surgeries for colorectal carcinoma. Dis Colon Rectum 44: 223–230PubMedCrossRef
18.
Rullier E, Sa Cunha A, Couderc P, Rullier A, Gontier R, Saric J (2003) Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer. Br J Surg 90: 445–451PubMedCrossRef
19.
Tsang WWC, Chung CC, Kwok SY, Li MKW (2005) Minimally invasive surgery for rectal cancer. Surg Clin North Am 85: 61–73PubMedCrossRef
20.
Uchiyama K, Takifuji K, Tani M, Onishi H, Yamaue H (2002) Effectiveness of the clinical pathway to decrease length of stay and cost for laparoscopic surgery. Surg Endosc 16: 1594–1597PubMedCrossRef
21.
Watanabe M, Teramoto T, Hasegawa H, Kitajima M (2000) Laparoscopic ultralow anterior resection combined with per anum intersphincteric rectal dissection for lower rectal cancer. Dis Colon Rectum 43: S94–S97PubMedCrossRef
22.
Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G, Clinical Outcomes of Surgical Therapy (COST) Study Group (2002) Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA 287: 321–328PubMedCrossRef
23.
Yamamoto S, Fujita S, Akasu T, Moriya Y (2004) A comparison of the complication rates between laparoscopic colectomy and laparoscopic low anterior resection. Surg Endosc 18: 1447–1451PubMedCrossRef
24.
Yamamoto S, Fujita S, Akasu T, Moriya Y (2005) Safety of laparoscopic intracorporeal rectal transection with double-stapling technique anastomosis. Surg Laparosc Endosc Percutan Tech 15: 70–74PubMedCrossRef
25.
Yamamoto S, Watanabe M, Hasegawa H, Kitajima M (2002) Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma. Dis Colon Rectum 45: 1648–1654PubMedCrossRef
Metadata
Title
Reduction of prolonged postoperative hospital stay after laparoscopic surgery for colorectal carcinoma
Authors
S. Yamamoto
S. Fujita
T. Akasu
K. Uehara
Y. Moriya
Publication date
01-09-2006
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 9/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-005-0651-2

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