| Autor: |
Gertallah, Loay M., Abdelaziz, Ahmed M., Elagrody, Ahmed I., Allam, Ahmed S., Elbaz, Mohamed, Ghoname, Mahmod, Sherbeiny, Mahmoud, Sharaf, Ahmed L., Harb, Ola A., Abdelaziz, Mahmoud, Negm, Mohamed |
| Předmět: |
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| Zdroj: |
World Journal of Laparoscopic Surgery; Jan-Apr2024, Vol. 17 Issue 1, p38-43, 6p |
| Abstrakt: |
Background: Using minimally invasive surgeries (MISs) in non-elective and urgent cases was assessed by many previous studies and found to be nearly similar to and even better than open surgeries. There was no sufficient data regarding long-term, follow-up, tumor recurrence, or survival data of studied patients in those studies. Aim of our study is to compare performing MIS and open colectomy in patients undergoing urgent (nonemergency, non-elective) colectomies, regarding primary outcomes of 30-day morbidity and mortality, secondary short-term outcomes, long-term and follow-up findings of included patients. Patients and methods: A total of 200 patients were included, and we divided them into two groups according to the performed surgical approach: The first group included 100 patients who underwent MISs and the second group underwent open surgery and included 100 patients. We evaluated the primary patients' outcome which was 30-day postoperative morbidity and mortality. Secondary evaluated patients' outcomes included; ICU admissions, surgical reintervention, wound infection or dehiscence, postoperative ileus, postoperative leakage at an anastomotic site, and occurrence of intra-abdominal infections. Long-term evaluated patients' outcomes included the occurrence of incisional hernias and oncological outcomes as overall survival rates and recurrence rates. Results: Regarding demographic and baseline data, patients who underwent open surgery were older (65 years vs 58 years, p < 0.001). More females underwent open surgery (54% vs 50%, p = 0.002). Overweight and obese patients were more likely to have MIS colectomy (p < 0. 001). There is a statistically significant relation between approach and all histopathological types (24.2% within the laparoscopic approach vs 11.6% within the open approach had mucoid carcinoma), N stage (82.8% within the laparoscopic approach vs 43.8% within open the approach had N stage 0), American Joint Committee on Cancer (AJCC) stage (63.8% within laparoscopic approach vs 20.8% within open approach had AJCC stage II) Open colectomy were liable to be diagnosed with acute diverticulitis and volvulus (p < 0.001). Operative time is longer in MIS patients in comparison to open colectomy patients the median time to complete an MIS colectomy was 21 minutes longer (p < 0.001). Postoperative mortality is less in MIS patients than the open surgery patients. On univariable analysis, 30-day postoperative mortality following MIS colectomy was lower than that after open surgery (p < 0.05). Conclusions: Using MIS in urgent colectomy is associated with less postoperative, morbidity, mortality, short-term complications, and longterm complications than open colectomy. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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