Laparoscopic sigmoid resection for diverticular disease has no advantages over open approach: midterm results of a randomized controlled trial

Purpose  

Elective laparoscopic sigmoid resection (LSR) for symptomatic diverticular disease is supposed to have significant short-term advantages compared to open surgery (open sigmoid resection (OSR)). This opinion is rather based on inferences from trials on colonic resections for malignant diseases or minor laparoscopic surgery. This randomized controlled trial was conducted to compare quality of life as well as morbidity and clinical outcome after LSR vs. OSR following a midterm follow-up period.     

Elective Open versus Laparoscopic Sigmoid Colectomy for Diverticular Disease: A Meta-Analysis with the Sigma Trial

Background  

A meta-analysis of published literature comparing open versus laparoscopic elective sigmoid resections for diverticular disease was conducted.     

Laparoscopic versus open sigmoid resection for diverticular disease: follow-up assessment of the randomized control Sigma trial

Background  

The short-term results of the Sigma trial show that laparoscopic sigmoid resection (LSR) used electively for diverticular disease offers advantages over open sigmoid resection (OSR). This study aimed to compare the overall mortality and morbidity rates after evaluation of the clinical outcomes at the 6-month follow-up evaluation.     

The Sigma-trial protocol: a prospective double-blind multi-centre comparison of laparoscopic versus open elective sigmoid resection in patients with symptomatic diverticulitis

Backround  

Diverticulosis is a common disease in the western society with an incidence of 33–66%. 10–25% of these patients will develop diverticulitis. In order to prevent a high-risk acute operation it is advised to perform elective sigmoid resection after two episodes of diverticulitis in the elderly patient or after one episode in the younger (< 50 years) patient. Open sigmoid resection is still the gold standard, but laparoscopic colon resections seem to have certain advantages over open procedures. On the other hand, a double blind investigation has never been performed. The Sigma-trial is designed to evaluate the presumed advantages of laparoscopic over open sigmoid resections in patients with symptomatic diverticulitis.     

Predictive risk factors for intra- and postoperative complications in 526 laparoscopic sigmoid resections due to recurrent diverticulitis: a multivariate analysis

Background  

Laparoscopic sigmoid resection is a feasible and frequent operation for patients who suffer from recurrent diverticulitis. There is still an ongoing debate about the optimal timing for surgery in patients who suffer from recurrent diverticulitis episodes. In elective situations the complication rate for this procedure is moderate, but there are patients at high risk for perioperative complications. The few identified risk factors so far refer to open surgery. Data for the elective laparoscopic approach is rare. The objective of this study was to identify potential predictive risk factors for intra- and postoperative complications in patients who underwent laparoscopic sigmoid resection due to diverticular disease.     

Long-term oncologic outcomes of laparoscopic radical nephrectomy for kidney cancer resection: Dundee cohort and metaanalysis of observational studies

Background  

The long-term oncologic outcome of laparoscopic radical nephrectomy compared with that of open radical nephrectomy remains unclear. A few case series with follow-up periods longer than 5 years are reported in the literature. The existing literature is focused primarily on early and intermediate outcomes of laparoscopic radical nephrectomy. This study aimed to assess the outcome of laparoscopic radical nephrectomy for localized disease compared with open surgery.     

Acute laparoscopic intervention for diverticular disease (AIDD): a feasible approach

Introduction  

Early laparoscopic rectosigmoid resection for acute complicated diverticulitis may avoid secondary hospital stay and stoma-related complications. Benefits of elective surgical therapies could advance the early laparoscopic approach for acute sigmoid diverticulitis.     

Single-incision versus conventional laparoscopic sigmoid colectomy: a case-matched series

Background  

Single-incision laparoscopic surgery is an emerging modality that has proven to be safe and feasible for colon resection in multiple case reports and series. Nonetheless, comparative analyses with established techniques are limited in the published literature. We evaluated the efficacy of single-incision laparoscopic colectomy (SILC) for the treatment of sigmoid disease through a matched-case comparison with conventional laparoscopic colectomy (CLC).     

A single surgeon’s experience with 54 consecutive cases of multivisceral resection for locally advanced primary colorectal cancer: can the laparoscopic approach be performed safely?

Background  

Laparoscopic resection for colorectal cancer has become popular. However, no previous studies have compared the laparoscopic and open approaches for colorectal cancer adherent to adjacent organs. This study analyzed the short- and long-term survival outcomes after laparoscopic multivisceral resection of the locally advanced primary colorectal cancer compared with open procedure in an effort to address appropriate patient selection.     

Laparoscopic-Assisted and Open High Anterior Resection within an ERAS Protocol

Background  

Due to potentially superior short-term outcomes compared with open colorectal surgery, laparoscopic surgery is currently being implemented in clinical practice worldwide. In parallel, enhanced recovery after surgery (ERAS) programs are shown to improve postoperative recovery in open colorectal surgery. This study reports outcomes in laparoscopic versus open surgery in conjunction with compliance to the ERAS protocol.     

A prospective study demonstrating the reliability and validity of two procedure-specific evaluation tools to assess operative competence in laparoscopic colorectal surgery

Background

Laparoscopic colorectal surgery is considered an advanced minimally invasive procedure with a long, variable learning curve. Developing an evaluation tool is essential to ensure that individuals reach a certain level of competence prior to performing this procedure independently. To achieve standardization and wide implementation, an assessment tool must be reflective of practice across many institutions.

Study design

The purpose of this study is to validate two procedure-specific evaluation tools for laparoscopic colorectal surgery that were developed using innovative consensus methodology. Two procedure-specific rating scales for laparoscopic right and sigmoid colectomy were created using the Delphi method. Nine novice and nine expert laparoscopic sigmoid colectomy videos were prospectively collected, and nine novice and ten expert laparoscopic right colectomy videos were recorded. The experts rated the videos using the procedure-specific technical skills evaluation tool for either laparoscopic right colectomy or laparoscopic sigmoid colectomy.

Results

There were statistically significant differences between the expert and novice scores on the laparoscopic right colectomy evaluation tool: the median score of novices was 63.8% and the expert score was 73.1% (p?=?0.02). Similarly, there was a significant difference between the median novice score on the sigmoid tool (58.6%) compared with the median expert score (70.7%) (p?=?0.003). Cronbach’s alpha was 0.82 for the right colectomy evaluation tool and 0.79 for the sigmoid rating scale.

Conclusions

The procedure-specific evaluation tools for laparoscopic right and sigmoid colectomy demonstrate strong reliability and construct validity, and have the potential to be used for technical skills assessment and feedback.     

Comparing the Clinical and Economic Impact of Laparoscopic Versus Open Liver Resection

Background  

Laparoscopic liver resection has thus far not gained widespread acceptance among liver surgeons. Valid questions remain regarding the relative clinical superiority of the laparoscopic approach as well as whether laparoscopic hepatectomy carries any economic benefit compared with open liver surgery.     

Robotic gastrectomy for gastric cancer: surgical techniques and clinical merits

Background  

Robotic gastrectomy in the setting of gastric cancer is reported by some investigators. However, no study has compared robotic surgery with open or laparoscopic surgery for patients with gastric cancer. This study aimed to determine the clinical benefits of robotic gastrectomy over open and laparoscopic gastrectomy for the treatment of gastric cancer.     

Laparoscopic versus open sigmoid resection for diverticulitis: long-term results of a prospective, randomized trial

Background  

Elective laparoscopic sigmoid resection for diverticulitis has proven short-term benefits, but little data are available from prospective randomized trials regarding long-term outcome, quality of life, and functional results.     

Robotic-assisted laparoscopic surgery for recurrent diverticulitis: experience in consecutive cases and a review of the literature

Background  

Robotic-assisted laparoscopic surgery has recently gained enthusiasm for application in colorectal surgery. We present the safety and feasibility of using the da Vinci^? robotic system for the surgical treatment of sigmoid diverticulitis.     

Laparoscopic resection vs. open liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: a case-matched study

Background  

Studies that compare laparoscopic to open liver resection for hepatocellular carcinoma (HCC) in cirrhotic patients are rare and may have suffered from low patient numbers. This work was designed to determine the impact of laparoscopic resection on postoperative and long-term outcomes in a large series of cirrhotic patients with hepatocellular carcinoma (HCC) compared with open resection.     

Operation time and body mass index are significant risk factors for surgical site infection in laparoscopic sigmoid resection: a multicenter study

Background  

Surgical site infection (SSI) in patients who underwent colorectal surgery is a common complication associated with increased morbidity and costs. The aim of this study was to assess risk factors for SSI in laparoscopic sigmoid resection for benign disease.     

Comparison of laparoscopic and open colorectal resections for patients undergoing simultaneous R0 resection for liver metastases

Background  

The role of laparoscopic colorectal resection for patients undergoing a simultaneous operation for liver metastases had not been established. This study compared the outcomes between laparoscopic and open colorectal resections for patients undergoing simultaneous surgery for liver metastases.     

Laparoscopic sigmoid resection with transrectal specimen extraction has a good short-term outcome

Background  

Transrectal specimen extraction in laparoscopic sigmoid resection avoids a muscle-split incision for specimen retrieval. A technique for transrectal specimen extraction is described, and the results of a pilot study concerning feasibility are presented.