LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS?

Nenhuma Miniatura disponível
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Dimensions
Título da Revista
ISSN da Revista
Título do Volume
Editora
COLEGIO BRASILEIRO CIRURGIA DIGESTIVA-CBCD
Autores
GERBASI, Lucas
Citação
ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA-BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY, v.36, article ID e1792, 5p, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
BACKGROUND: The laparoscopic approach considerably reduced the morbidity of colorectal surgery when compared to the open approach. Among its benefits, we can highlight less intraoperative bleeding, early oral intake, lower rates of surgical site infection, incisional hernia, and postoperative pain, and earlier hospital discharge. AIMS: To compare the perioperative morbidity of right versus left colectomy for cancer and the quality of laparoscopic oncologic resection. METHODS: Retrospective analysis of patients submitted to laparoscopic right and left colctomy between 2006 and 2016. Postoperative complications were classified using the Clavien-Dindo scale, 30 days after surgery. RESULTS: A total of 293 patients were analyzed, 97 right colectomies (33.1%) and 196 left colectomies (66.9%). The averageage was 62.8 years. The groups were comparable in terms of age, comorbidities, body mass index, and the American Society of Anesthesiology (ASA) classification. Preoperative transfusion was higher in the right colectomy group (5.1% versus 0.4%, p=0.004, p<0.05). Overall, 233 patients (79.5%) had no complications. Complications found were grade I and II in 62 patients (21.1%) and grade III to V in 37 (12.6%). Twenty-three patients (7.8%) underwent reoperation. The comparison between left and right colectomy was not statistically different for operative time, conversion, reoperation, severe postoperative complications, and length of stay. The anastomotic leak rate was comparable in both groups(5.6% versus 2.1%, p=0.232, p>0.05). The oncological results were similar in both surgeries. In multiple logistic regression, ASA statistically influenced the worst results (>= III; p=0.029, p<0.05). CONCLUSIONS: The surgical and oncological results of laparoscopic right and left colectomies are similar, making this the preferred approach for both procedures.
Palavras-chave
Colorectal Surgery, Colectomy, Intestinal Neoplasms, Morbidity
URI
https://observatorio.fm.usp.br/handle/OPI/58886
Referências
  1. Benedix F, 2010, DIS COLON RECTUM, V53, P57, DOI 10.1007/DCR.0b013e3181c703a4
  2. Bonjer HJ, 2009, LANCET ONCOL, V10, P44, DOI 10.1016/S1470-2045(08)70310-3
  3. Bonjer HJ, 2005, LANCET ONCOL, V6, P477, DOI 10.1016/S1470-2045(05)70221-7
  4. Campana JP, 2017, INT J COLORECTAL DIS, V32, P907, DOI 10.1007/s00384-017-2776-x
  5. Campos FG, 2021, ABCD-ARQ BRAS CIR DI, V34, DOI 10.1590/0102-672020210001e1575
  6. Clavien PA, 2009, ANN SURG, V250, P187, DOI 10.1097/SLA.0b013e3181b13ca2
  7. Guillou PJ, 2005, LANCET, V365, P1718, DOI 10.1016/S0140-6736(05)66545-2
  8. Hinojosa MW, 2007, AM SURGEON, V73, P945
  9. Hosmer DW., 2000, Applied Logistic Regression, DOI 10.1002/0471722146
  10. Kirkwood B. R., 2006, Essential medical statistics, V2nd
  11. Kupper BEC, 2023, ABCD-ARQ BRAS CIR DI, V36, DOI 10.1590/0102-672020230002e1729
  12. Kwaan MR, 2013, JAMA SURG, V148, P504, DOI 10.1001/jamasurg.2013.1205
  13. Lacy AM, 2002, LANCET, V359, P2224, DOI 10.1016/S0140-6736(02)09290-5
  14. Masoomi H, 2011, J GASTROINTEST SURG, V15, P2023, DOI 10.1007/s11605-011-1655-y
  15. Nfonsam Valentine, 2016, Cancer Treat Commun, V8, P1
  16. Sobrado LF, 2023, ABCD-ARQ BRAS CIR DI, V36, DOI 10.1590/0102-672020230052e1770
  17. Turrado-Rodriguez V, 2016, SURG ENDOSC, V30, P1413, DOI 10.1007/s00464-015-4345-0
  18. Veyrie N, 2007, J AM COLL SURGEONS, V205, P785, DOI 10.1016/j.jamcollsurg.2007.06.284

Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT