Document Detail


Colorectal resection by a minilaparotomy approach vs. conventional operation for colon cancer. Results of a prospective randomized trial.
MedLine Citation:
PMID:  18251141     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The aim of this study was to evaluate the outcome of patients undergoing colorectal resection for colon cancer using a minilaparotomy approach or conventional surgical procedure. METHODOLOGY: In a prospective randomized trial, twenty consecutive patients undergoing colon resection by minilaparotomy and 26 patients undergoing conventional open colorectal resection were evaluated. Immunologic, metabolic and hemodynamic studies were performed in all patients. Cell surface markers were used to characterize Th1/2 balance, using flow cytometry. Indirect calorimetry to measure energy expenditure, and pulse dye densitometry for a hemodynamic study were performed in patients until 14 POD. RESULTS: The lengths of laparotomy incisions were 7.5+/-1.5 cm and 20.5+/-2.5 cm in the minilaparotomy and conventional group, respectively. Mean operative time, morbidity and postoperative hospital stay of the two groups was not significantly different. However, mean operative blood loss, days to p.o. liquids and walking, and amount of analgesic usage were significantly less in the minilaparotomy group. The postoperative ratio of Th1/2 in CD4+T cells was decreased in both groups, but no significant difference was seen between the groups. Significant increase of resting energy expenditure and cardiac index was seen until day 3 in the conventional group, whereas those values increased until day 1 in the minilaparotomy group. CONCLUSIONS: Compared with conventional colorectal resection for colon cancer, colorectal resection by minilaparotomy results in a more rapid return of bowel function, less pain and host response. However, the alternations of the host response for surgical stress between the two groups are similar in the early postoperative stage (days 1-2).
Authors:
M Ishikawa; M Nishioka; N Hanaki; T Miyauchi; Y Kashiwagi; H Miki
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  54     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2007 Oct-Nov
Date Detail:
Created Date:  2008-02-06     Completed Date:  2008-03-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  1970-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, National Kochi Hospital, Japan. masa1192@tokushima-med.jrc.or.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
CD4 Lymphocyte Count
Calorimetry, Indirect
Colectomy
Colonic Neoplasms / physiopathology,  surgery*
Energy Metabolism
Female
Flow Cytometry
Hemodynamics
Humans
Interferon-gamma / analysis
Interleukin-4 / analysis
Laparotomy / methods
Male
Middle Aged
Prospective Studies
Surgical Procedures, Minimally Invasive
Chemical
Reg. No./Substance:
207137-56-2/Interleukin-4; 82115-62-6/Interferon-gamma

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