Clinical outcomes of 103 hand-assisted laparoscopic surgeries for left-sided colon and rectal cancer: single institutional review.
OBJECTIVE
The laparoscopic colectomy is avoided principally because of its technical difficulty, steep learning curve, and increased operative time. Hand-assisted laparoscopic surgery (HALS) is an alternative technique that addresses these problems while preserving the short-term benefits of a laparoscopic colectomy. Our study was aimed to describe the characteristics of patients admitted due to left-sided colon and rectal cancer for HALS.


METHODS
A prospectively maintained database was used to identify patients who underwent HALS at the Institute of Oncology, Vilnius University, from July 1, 2009, to October 1, 2012.


RESULTS
One hundred-three HALS colorectal resections were performed. The patients' mean age was 64 ± 13.4 years. There were 46 male and 57 female patients. The body mass index was 27.3 ± 5.8 kg/m(2). Forty-three patients (41.8%) had experienced prior abdominal surgery. The mean HALS time was 105 minutes (range, 55-85 minutes). The conversion rate was 2.7% (3/103). The median of return of gastrointestinal function was 2.5 days (range, 2.2-4.5 days). The median length of hospital stay was 9 days. The postoperative complication and mortality rates were 10.7% and 0.97%, respectively. Four incisional hernias (3.9%) were seen at a mean follow-up of 7.0 ± 3.4 months. None of the patients had a trocar or a hand-port site recurrence.


CONCLUSIONS
A HALS colorectal resection is a safe and effective technique, and it provides all the benefits of minimally invasive surgery.
Center of Oncosurgery, Institute of Oncology, Vilnius University, Clinic of Internal, Family Medicine and Oncology, Faculty of Medicine, Vilnius, Lithuania.
Narimantas Evaldas
NE
Samalavicius
Department of Surgery, Gastrointestinal Unit, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Rakesh Kumar
RK
Gupta
Vilnius University, Institute of Oncology, Vilnius, Lithuania.
Audrius
A
Dulskas
Vilnius University, Institute of Oncology, Vilnius, Lithuania.
Darius
D
Kazanavicius
Vilnius University, Institute of Oncology, Vilnius, Lithuania.
Kestutis
K
Petrulis
Aintree University Hospitals NHS Foundation Trust, University Hospital Aintree, Liverpool, UK.
Raimundas
R
Lunevicius
Hand-assisted laparoscopy; Laparoscopic colectomy; Short-term outcomes