Laparoscopic colon resection by a single general surgeon in a community hospital: a review of 200 consecutive cases.
BACKGROUND
We assessed a single surgeon's experience on laparoscopic colorectal surgery (LCR) at a single non academic, community hospital. The surgeon was trained in minimally-invasive techniques and robotic surgery with >500 procedures at another non-university hospital, either as operating surgeon or as assistant.


METHODS
Short-term outcome of patients undergoing LCR for benign/neoplastic disease (June 2005-September 2007) was assessed.


RESULTS
A total of 208 patients (104 males, 104 females; median age 69.1 years, Interquartile Range (IQR):59.3-76.6) underwent LCR. Over 70% of the operations were performed for cancer. Left hemicolectomy was performed in 102 patients (49.1%), right hemicolectomy in 50 (24%), anterior resection in 40 (19.2%), other procedures in 16 (7.7%). One-hundred-ninety (91.3%) operations were elective. The median operative time was 180 min (IQR:150-210). Conversion rate was 4.8%: 3.4% for benign and 5.4% for neoplastic disease (p = n.s.). The median lymph node harvest in cancer patients was 16 (IQR:12-20). Mortality and overall morbidity rates were 0.5% and 13%, with no significant difference between benign and malignant disease, colon and rectum, elective and non elective operations.


CONCLUSIONS
The outcomes of LCR surgery performed by a well-trained laparoscopic surgeon working in a community hospital are comparable with results from academic health science centers.
Fiscon
Valentino
V
Department of General Surgery, Azienda ULSS 15 Alta Padovana, Cittadella (Padova), Italy. Valentino.fiscon@virgilio.it
Frigo
Flavio
F
Migliorini
Giovanni
G
Portale
Giuseppe
G
Lazzarini
Elvio
E
D000368:Aged; D016009:Chi-Square Distribution; D003082:Colectomy / Q000379:methods; D003108:Colonic Diseases / Q000401:mortality / Q000601:surgery*; D005260:Female; D013502:General Surgery / Q000592:standards; D006764:Hospitals, Community; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D016896:Treatment Outcome