Gasless laparoscopy-assisted versus open resection of small bowel lesions.
BACKGROUND
We had developed an innovative method of minimally invasive surgery using gasless laparoscopy in resection of the small bowel lesion. This study aimed at evaluating the feasibility and efficacy of this procedure by comparison with traditional open small bowel surgery.


METHODS
A wedge or segmental resection of the small bowel for removal of the lesion was performed in 25 patients at National Taiwan University Hospital from September 2006 to January 2009. Thirteen patients underwent gasless laparoscopy-assisted surgery (GLAS), and 12 patients underwent open surgery. The perioperative characteristics and clinical results between the two groups were compared.


RESULTS
The demographics, clinical data, lesion size, and operative time were comparable between the GLAS and open surgery groups, but the wound length and blood loss were significantly less in the GLAS group (P < 0.001 and P = 0.021, respectively). The time to first postoperative flatus and first oral intake were significantly less in the GLAS group (P = 0.007 and 0.036, respectively). No major complication occurred in either group. No tumor recurrence was found after a median follow-up period of 14 months (range = 1-30) in the GLAS group.


CONCLUSIONS
GLAS for resection of the small bowel may be a feasible and safe procedure for the small bowel lesions. It has the advantages of better cosmetic outcome, less blood loss, and earlier recovery of bowel movement.
Huang
Chun-Chieh
CC
Division of General Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
Yang
Ching-Yao
CY
Wu
Ming-Hsun
MH
Wang
Ming-Yang
MY
Yeh
Chi-Chuan
CC
Lai
I-Rue
IR
Chen
Chiung-Nien
CN
Lin
Ming-Tsan
MT
D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000556:secondary / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000379:methods; D004379:Duodenal Neoplasms / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery*; D006801:Humans; D007078:Ileal Neoplasms / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery; D007580:Jejunal Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult