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Laparoscopic colorectal cancer surgery for palliation

Authors
Milsom J.W.Kim S.H.Hammerhofer K.A.Fazio V.W.
Issue Date
2000
Publisher
Lippincott Williams and Wilkins
Keywords
Colorectal cancer; Laparoscopy; Palliation; Resection; Stoma creation
Citation
Diseases of the Colon and Rectum, v.43, no.11, pp.1512 - 1516
Indexed
SCOPUS
Journal Title
Diseases of the Colon and Rectum
Volume
43
Number
11
Start Page
1512
End Page
1516
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/32634
DOI
10.1007/BF02236729
ISSN
0012-3706
Abstract
PURPOSE: The aim of this study was to review our experience with laparoscopic colorectal cancer surgery for palliative purposes anti to assess its safety and efficacy. METHODS: This was a prospective analysis of 30 patients with incurable colorectal cancer considered for laparoscopic surgery for palliative purposes. RESULTS: Resection of a single segment of the bowel was performed in 15 patients (6 right and 1 left colectomies and 8 proctosigmoidectomies). One patient underwent both right colectomy and sigmoidectomy because of double lesions. Stoma creation only was performed in 11 patients (5 colostomies and 6 ileostomies). Three patients were converted to an open procedure. For resection, median operative time was 170 minutes, and median estimated blood loss was 150 ml. For stoma creation, median operative time was 60 minutes, and median blood loss was 50 ml. There were no intraoperative complications. Postoperative death occurred in two severely debilitated patients after stoma creation. One patient developed a pulmonary embolism eight days postoperatively, later dying of pulmonary failure. Another patient died six hours after loop colostomy. Autopsy was refused. There were no other postoperative complications. Median time to passage of flatus was two days and of stool five days after resection and two days for both flatus and stool after stoma creation. Median time to discharge was eight days after resection and seven days after stoma creation. All patients were able to eat and recover normal bowel function. Among the resection group, six patients died (median time to death, 12 months) during a median follow-up period of 13 months. Among the stoma creation group, five patients died (median time to death, 8 months) during median follow-up period of ten months. There were no port-site recurrences. CONCLUSION: The laparoscopic approach for patients with incurable colorectal cancer can provide effective palliation with avoidance of a major laparotomy in the majority of cases.
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2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles

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