Feasibility and Outcome of Enhanced Recovery Programs in Laparoscopic versus Open Elective Colectomy for Left Side Colonic Carcinoma Surgery

M. A. Fadey, Zeyad Mohsen Elbagoury, A. A. Dawood, Yaser H Metwally, Mohamed E. Hasan, Ayman T. Mohamed
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Abstract

Background : Enhanced recovery programs (ERP) have emerged to enhance surgical outcomes and decrease expenses. However, these are still opposed by the traditional measures in the treatment of colorectal carcinoma Objectives : This study aimed to compare laparoscopic versus open left-side cancer colon resection under the guidelines of ERP. Subjects and methods : sixty-two patients with left side cancer colon were divided into two equal groups: group (A) received laparoscopic colectomy (LC) and group (B) received open colectomy (OC). ERP were applied. Follow-up was planned for 1 month for the early outcomes. Result s: the mean age of the included subjects was 49.2 ± 6.23 and 47.8 ± 6.9 years in LC and OC groups respectively. There was a significantly less hospital stay in LC group when compared with OC group (P=0.001). Significantly more pain was reported in OC Group (P=0.001%). There was a significant difference regarding postoperative complications where Postoperative nausea and vomiting (PONV), ileus, wound infection and wound dehiscence were statistically higher in OC group when compared with patients who received LC (P=0.001). Conclusion: Laparoscopic left-sided colectomy, when establishing ERP, is safer, more dependable, easier to use, and more appropriate than open left-sided colon cancer surgery—especially when performed by skilled surgeons with fewer postoperative problems and shorter hospital stays.
左侧结肠癌手术中腹腔镜与开腹选择性结肠切除术中强化恢复计划的可行性和结果
背景:为提高手术效果和降低费用,出现了强化恢复计划(ERP)。目的:本研究旨在比较在ERP指导下腹腔镜与开腹左侧结肠癌切除术的效果。研究对象和方法:将 62 名左侧结肠癌患者分为两组:A 组接受腹腔镜结肠切除术(LC),B 组接受开腹结肠切除术(OC)。应用 ERP。计划随访 1 个月以了解早期结果。结果:腹腔镜结肠切除术组和开腹结肠切除术组受试者的平均年龄分别为(49.2 ± 6.23)岁和(47.8 ± 6.9)岁。LC 组的住院时间明显少于 OC 组(P=0.001)。OC组的疼痛报告明显较多(P=0.001%)。在术后并发症方面,OC 组患者的术后恶心呕吐 (PONV)、回肠梗阻、伤口感染和伤口裂开的发生率明显高于 LC 组患者(P=0.001)。结论与开腹左侧结肠癌手术相比,腹腔镜左侧结肠切除术在建立ERP时更安全、更可靠、更易操作、更合适,尤其是由技术熟练的外科医生进行手术时,术后问题更少,住院时间更短。
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