Feasibility and safety of laparoscopic resection following stent insertion for obstructing left-sided colon cancer.
10.4174/jkss.2013.85.6.290
- Author:
Seoung Yoon RHO
1
;
Sung Uk BAE
;
Se Jin BAEK
;
Hyuk HUR
;
Byung Soh MIN
;
Seung Hyuk BAIK
;
Kang Young LEE
;
Nam Kyu KIM
Author Information
1. Division of Colorectal Surgery, Department of Surgery, Colorectal Cancer Clinic, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. sabiston0000@hanmail.net
- Publication Type:Comparative Study ; Original Article
- Keywords:
Colonic neoplasms;
Stents;
Laparoscopy
- MeSH:
Anastomotic Leak;
Colon*;
Colonic Neoplasms*;
Conversion to Open Surgery;
Diet;
Humans;
Ileostomy;
Ileus;
Laparoscopy;
Length of Stay;
Lymph Nodes;
Mortality;
Postoperative Complications;
Stents*;
Urinary Bladder
- From:Journal of the Korean Surgical Society
2013;85(6):290-295
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of this study was to assess the feasibility and safety of laparoscopic resection following the insertion of self-expanding metallic stents (SEMS) for the treatment of obstructing left-sided colon cancer. METHODS: Between October 2006 and December 2012, laparoscopic resection following SEMS insertion was performed in 54 patients with obstructing left-sided colon cancer. RESULTS: All 54 procedures were technically successful without the need for conversion to open surgery. The median interval from SEMS insertion to laparoscopic surgery was 9 days (range, 3-41 days). The median surgery time was 200 minutes (range, 57-444 minutes), and estimated blood loss was 50 mL (range, 10-3,500 mL). The median time to soft diet was 4 days (range, 2-8 days) and possible length of stay (hypothetical length of stay according to the discharge criteria) was 7 days (range, 4-22 days). The median total number of lymph nodes harvested was 23 (range, 8-71) and loop ileostomy was performed in 2 patients (4%). Six patients (11%) developed postoperative complications: 2 patients with anastomotic leakages, 1 with bladder leakage, and 3 with ileus. There was no mortality within 30 days. CONCLUSION: The present study shows that the presence of a SEMS does not compromise the laparoscopic approach. Laparoscopic resection following stent insertion for obstructing left-sided colon cancer could be performed with a favorable safety profile and short-term outcome. Large-scale comparative studies with long-term follow-up are needed to demonstrate a significant benefit of this approach.
