Comparison and short-term outcomes between hand-assisted laparoscopic surgery and conventional laparoscopic surgery for anterior resections of left-sided colon cancer.
BACKGROUND
Hand-assisted laparoscopic surgery has been introduced as an alternative to conventional laparoscopic surgery. This study compared the efficacies and short-term clinical outcomes between hand-assisted laparoscopic anterior resection (HAL-AR) and conventional laparoscopic anterior resection (CL-AR) for treating left-sided colon cancer.


METHODS
We retrospectively analyzed 248 patients who underwent anterior resection for colon cancer (118 HAL-AR and 128 CL-AR) between May 2000 and December 2006. The collected data included the perioperative and short-term oncologic outcomes.


RESULTS
There were no significant differences between the HAL-AR and CL-AR groups, except for the operation time and the size of the primary tumor. The operation time of the HAL-AR group was significantly shorter than that of the CL-AR group (p = 0.004), and the size of the primary tumor in the HAL-AR group was significantly larger than that of the CL-AR group (p = 0.019). The operating time of the HAL-AR group reached an earlier mean plateau than did that of the CL-AR group. Before and after reaching the plateau, there were no differences in the perioperative results between the two groups. The operating time for the HAL-AR group was significantly shorter than that of the CL-AR group after reaching a plateau (p = 0.012). The short-term outcomes for both groups were similar in terms of survival and recurrence (p = 0.996 and p = 0.476, respectively).


CONCLUSIONS
Hand-assisted laparoscopic anterior resection has a shorter operative time than does CL-AR and is more successful than CL-AR for resecting larger tumors, while both procedures result in similar short-term oncologic outcomes. Hand-assisted laparoscopic anterior resection is thought be a comparable operative technique for anterior resection of left-sided colon cancer.
Yun
Hae Ran
HR
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Cho
Yong Kwon
YK
Cho
Yong Beom
YB
Kim
Hee Cheol
HC
Yun
Seong Hyeon
SH
Lee
Woo Yong
WY
Chun
Ho-Kyung
HK
D003110:Colonic Neoplasms / Q000601:surgery*; D003710:Demography; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D013997:Time Factors; D016896:Treatment Outcome