What are the reported outcomes for laparoscopic left hemicolectomy?

Updated: Apr 13, 2020
  • Author: David B Stewart, Sr, MD, FACS, FASCRS; Chief Editor: Vikram Kate, MBBS, MS, PhD, FRCS, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed)  more...
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Answer

Studies have generally found that the outcomes of laparoscopic colon resection are at least comparable to those of open resection. [18, 19, 20]

In a retrospective study using a population-based database of patients undergoing elective colectomy over a period of 7 years, Wei et al compared the outcomes of MIS and OS and evaluated trends in MIS (laparoscopic or robotic). [21] The authors noted a rising trend in MIS rates and a tenfold increase in robotic surgery. Although the operating time was longer in the MIS group, the rates of complications (eg, anastomotic leakage, bleeding, and infection) were lower, the length of stay was shorter, and total hospital costs were reduced in comparison with OS.

The safety and feasibility of repeat laparoscopic colorectal resection (LCRR) were assessed in a study by Zarzavadjian le Bian et al, [22] which included 23 patients who had colorectal cancer (CRC; n = 11) or benign conditions (dysplasia [n = 5], anastomotic stricture [n = 4], or IBD [n = 3]) and underwent right-side resection, left-side resection, or proctectomy. Thirteen (57%) patients required conversion to laparotomy (12 for intense adhesions). Although repeat LCRR had a higher conversion rate, a longer operating time, and greater intraoperative blood loss than primary LCRR, postoperative outcomes were not compromised.

Although single-port laparoscopic approaches have garnered considerable interest, concern has been expressed about whether they yield outcomes comparable to those of multiport approaches. A case-match study by Marks et al concluded that single-port colorectal surgery is a safe alternative to multiport surgery across the full array of procedures (including left colectomy) in equivalent patients. [23]  A double-blind randomized controlled trial by Maggiori et al concluded that single-port laparoscopic colectomy conferred no additional benefit other than cosmetic result as compared with multiport laparoscopic colectomy. [24]


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