title: Feasibility of hand-assisted laparoscopic surgery as compared to open surgery for sigmoid colon cancer: a case-controlled study.
abstract: OBJECTIVE
  The aim of this study was to evaluate short-term clinical outcomes by comparing hand-assisted laparoscopic surgery (HALS) with open surgery for sigmoid colon cancer.
  
  
  METHODS
  Twenty-six patients who underwent a hand-assisted laparoscopic anterior resection (HAL-AR group) and 52 patients who underwent a conventional open anterior resection during the same period were enrolled (open group) in this study with a case-controlled design.
  
  
  RESULTS
  Pathologic parameters were similar between the two groups. The incidences of immediate postoperative leukocytosis were 38.5% in the HAL-AR group and 69.2% in the open group (P = 0.009). There were no significant differences between the two groups as to leukocyte count, hemoglobin, and hematocrits (P = 0.758, P = 0.383, and P = 0.285, respectively). Of the postoperative recovery indicators, first flatus, sips of water and soft diet started on postoperative days 3, 5, 7 in the HALS group and on days 4, 5, 6 in the open group showed statistical significance (P = 0.021, P = 0.259, and P = 0.174, respectively). Administration of additional pain killers was needed for 1.2 days in the HAL-AR group and 2.4 days in the open group (P = 0.002). No significant differences in the durations of hospital stay and the rates of postoperative complications were noted, and no postoperative mortality was encountered in either group.
  
  
  CONCLUSIONS
  The patients with sigmoid colon cancer who underwent a HAL-AR had a lower incidence of postoperative leukocytosis, less administration of pain killers, and faster first flatus than those who underwent open surgery. Clinical outcomes for patients' recovery and pathology status were similar between the two groups. Therefore, a HAL-AR for sigmoid colon cancer is feasible and has the same benefit as minimally invasive surgery.
authors.affiliation: Department of Surgery, Colorectal Cancer Center, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Nam
authors.forename: Eun-Joo
authors.initials: EJ
authors.lastname: Jung
authors.forename: Chun-Geun
authors.initials: CG
authors.lastname: Ryu
authors.forename: Jin Hee
authors.initials: JH
authors.lastname: Paik
authors.forename: Dae-Yong
authors.initials: DY
authors.lastname: Hwang
keywords: Anterior resection; Hand-assisted laparoscopic surgery; Minimally invasive surgery; Sigmoid colon cancer