Laparoscopic appendicectomy: a training model for laparoscopic right hemicolectomy?

Autor: Anne Pullyblank, K L R Cross, R. Soulsby, A. R. Dixon, S. Pandey, S. Slawik
Rok vydání: 2007
Předmět:
Zdroj: Colorectal Disease. 9:536-539
ISSN: 1463-1318
1462-8910
DOI: 10.1111/j.1463-1318.2007.01244.x
Popis: Objective To analyse the outcome of laparoscopic appendicectomy and right hemicolectomy and see if the surgical approach to the former can be applied to the latter. Method A prospective electronic laparoscopic database identified 330 appendicectomies and 78 right hemicolectomies (using this approach) between 1996 and 2005. Results Three hundred and thirty patients (188 males: median age 38 years, range 17–74 years) underwent laparoscopic appendicectomy; 270 (82%) were performed by trainees (higher surgical trainee 71%, basic surgical trainee 12%). The median operative time for trainees was 35 min (14–75 min) with a conversion rate 2%. There were no intra-operative complications. The postoperative complication rate excluding minor wound infection (5.5%) was 1.5%. There were no deaths. The median hospital stay was 2 days (1–15 days). The 30-day readmission rate was 1%. Seventy-eight patients (23–93 years) underwent laparoscopic right hemicolectomy during 2004/5; trainees performed parts thereof in the majority or all of the surgery in 25 cases. The median operation time was 55 min: trainees 115 (65–145 min). There was one conversion. The median hospital stay was 4 days (2–23 days) falling to 3 for the last 20 operations (1–8 days). There were two readmissions for wound sepsis and small bowel obstruction and three deaths (3.8%): anastomotic leak (one), C difficile infection leading to renal failure (one) and duodenal perforation (one). Conclusion Laparoscopic appendicectomy is a safe, predictable, easily learnt operation and an ideal model for learning the skills and principles required for more advanced laparoscopic colorectal interventions and in particular, right hemicolectomy.
Databáze: OpenAIRE
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