| Popis: |
Background: Colorectal cancer is considered the 3rd common malignancy worldwide responsible for 9% of all cancer incidence. Currently laparoscopy is widely practiced in colorectal cancer surgery. It is related to the surgeon's experience to do either lateral-to-medial or medial-to-lateral approach. The two laparoscopic approaches are currently practiced and there are conflicts of superiority of this over that and vice versa. We aimed to show the superiority of one procedure over the other regarding short-term outcomes.Patient and Methods: This is a prospective randomized study of laparoscopic colorectal surgery. One hundred patients were included in this study.Patients were divided to 2 equal groups medial to lateral (M-L) and lateral to medial group (L-M), 50 patients each. The study was conducted from Feb 2017 to May 2021 in Menoufia university hospital, in the general surgery department.The study endpoint was: The feasibility, technical efficacy, operative time, vascular or ureteric injury and other complications of both techniques. We collected data according to patient demographics, technique of laparoscopic mobilization, surgery duration, hospital stay, operative and post-operative complications and lymph node retrieval.Results: One hundred patients with comparable demographics criteria had laparoscopic colorectal cancer surgery. Sixty-one patients were males (61%) and 39 patients (39%) were females. Fifty patients (50 %) were performed using M-L technique and the other 50 patients (50.0%) were operated upon using the L-M approach. Lateral approach had an average 10±3 (4–22) lymph nodes with specimen compared to 17±4 (9–31) in the medial approach. There was no statistically significant difference in the major complication rate (Clavien-Dindo IV) between the two approaches. M-L approach showed significant shorter operative time than L-M approach in anterior resection and Rt hemicolectomy in favor of M-L approach p0.05Conclusion: Both approaches were feasible for colon cancer surgery. Laparoscopic M-L approach was found technically easier, and had less surgery related complications than the L-M approach. |
