TY - JOUR
T1 - Standardized approach to laparoscopic right colectomy
T2 - Outcomes in 70 consecutive cases
AU - Senagore, Anthony J.
AU - Delaney, Conor P.
AU - Brady, Karen M.
AU - Fazio, Victor W.
PY - 2004/11
Y1 - 2004/11
N2 - The purpose of this article is to describe a standard operative technique, postoperative care plan, and outcomes for laparoscopic right hemicolectomy. A consecutive series of patients requiring laparoscopic right colectomy for neoplasia from March 1999 to April 2003 at the Cleveland Clinic Foundation, Cleveland, OH, were analyzed. Data collected included age, gender, indication for surgery, American Society of Anesthesiology class, body-mass index, operative duration, length of hospital stay, complications, mortality, and 30-day readmission rate. Operative steps and instrumentation for the procedure were standardized. Conversion was performed when a sequential step could not be completed in a reasonable time frame. A standard perioperative care plan was used. From March 1999 through April 2003, 70 laparoscopic right hemicolectomies were attempted and 64 (90.1%) were completed. Indications for resection were cancer (30) and polyps (38). The mean operative time was 85 ± 32 minutes. Mean length of hospital stay was 3.2 ± 2 days for completed cases and 4.3 ± 2 days for converted cases. Anastomotic leaks occurred in 2 (2.8%) patients. The morbidity rate including the anastomotic leaks was 7.1%. There were no operative mortalities or port site tumor recurrences. Results indicate that a structured approach to laparoscopic right colectomy is associated with reasonable operative times, acceptable morbidity, and reductions in hospital stay.
AB - The purpose of this article is to describe a standard operative technique, postoperative care plan, and outcomes for laparoscopic right hemicolectomy. A consecutive series of patients requiring laparoscopic right colectomy for neoplasia from March 1999 to April 2003 at the Cleveland Clinic Foundation, Cleveland, OH, were analyzed. Data collected included age, gender, indication for surgery, American Society of Anesthesiology class, body-mass index, operative duration, length of hospital stay, complications, mortality, and 30-day readmission rate. Operative steps and instrumentation for the procedure were standardized. Conversion was performed when a sequential step could not be completed in a reasonable time frame. A standard perioperative care plan was used. From March 1999 through April 2003, 70 laparoscopic right hemicolectomies were attempted and 64 (90.1%) were completed. Indications for resection were cancer (30) and polyps (38). The mean operative time was 85 ± 32 minutes. Mean length of hospital stay was 3.2 ± 2 days for completed cases and 4.3 ± 2 days for converted cases. Anastomotic leaks occurred in 2 (2.8%) patients. The morbidity rate including the anastomotic leaks was 7.1%. There were no operative mortalities or port site tumor recurrences. Results indicate that a structured approach to laparoscopic right colectomy is associated with reasonable operative times, acceptable morbidity, and reductions in hospital stay.
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U2 - 10.1016/j.jamcollsurg.2004.06.021
DO - 10.1016/j.jamcollsurg.2004.06.021
M3 - Article
C2 - 15501105
AN - SCOPUS:6944242888
SN - 1072-7515
VL - 199
SP - 675
EP - 679
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
IS - 5
ER -