title: Right colon laparoscopic resection with three-trocar access and associated gynecological procedures in patients with colorectal cancer and ovarian metastases.
abstract: BACKGROUND
  Right laparoscopic colectomy was introduced to colorectal surgery later than the left colon procedure. Three-trocar laparoscopy has already been used successfully in the treatment of gynecological cancers. In the present study, we aimed to analyze the feasibility of performing an associated gynecological procedure following abdominal laparoscopic exploration and to evaluate the suitability of laparoscopic right colectomy for treating elderly patients.
  
  
  METHODS
  We conducted a review of prospectively collected data on 100 consecutive patients who were treated with right laparoscopic colectomy using three trocars from January 2005 to April 2010. We recorded the patients' age (<70 or > 70 years), ASA status, body mass index (BMI), pain on postoperative days 1 and 2 (POD 1, 2), nodes retrieved, laparotomic conversion, mean operative time, time to intestinal recovery, and length of postoperative stay.
  
  
  RESULTS
  All subjects were treated for cancer. Conversion to the laparotomic procedure was performed in 13/100, with no difference in terms of age. Operative time was longer for laparotomic conversion (p <0.05), with a longer postoperative stay. Elderly patients had higher ASA scores (p < 0.005); age did not influence the conversion rate or BMI status. Pain on POD 1 and 2 differed between the laparotomic and laparoscopic groups (p <0.0001). Associated procedures were performed in five subjects (3 oophorectomy and 2 cholecystectomy).
  
  
  CONCLUSIONS
  Laparoscopy using the three-trocar technique is a safe procedure for treating colon cancer, including in elderly patients, and enables associated gynecological laparoscopic procedures to be performed.
authors: Department of Surgical Science, University Hospital of Parma, Italy.
authors: P
authors: P
authors: Del Rio
authors: P
authors: P
authors: Dell'Abate
authors: N
authors: N
authors: Sianesi
authors: M
authors: M
authors: Fumagalli
authors: B
authors: B
authors: De Simone
authors: F
authors: F
authors: D'Addetta
authors: T S
authors: TS
authors: Patrelli
authors: M
authors: M
authors: Sianesi
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D007902:Length of Stay; D008198:Lymph Nodes / Q000473:pathology; D010051:Ovarian Neoplasms / Q000556:secondary* / Q000601:surgery*; D010052:Ovariectomy; D010149:Postoperative Pain; D011446:Prospective Studies; D013525:Surgical Instruments