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KMID : 0371320130850060290
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Journal of the Korean Surgical Society
2013 Volume.85 No. 6 p.290 ~ p.295
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Feasibility and safety of laparoscopic resection following stent insertion for obstructing left-sided colon cancer
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Rho Seoung-Yoon
Bae Sung-Uk
Baek Se-Jin
Hur Hyuk
Min Byung-Soh
Baik Seung-Hyuk
Lee Kang-Young
Kim Nam-Kyu
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Abstract
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Purpose:
The aim of this study was to assess the feasibility and safety of laparoscopic resection following the insertion of self-expanding metallic stents (SEMS) for the treatment of obstructing left-sided colon cancer.
Methods:
Between October 2006 and December 2012, laparoscopic resection following SEMS insertion was performed in 54 patients with obstructing left-sided colon cancer.
Results:
All 54 procedures were technically successful without the need for conversion to open surgery. The median interval from SEMS insertion to laparoscopic surgery was 9 days (range, 3-41 days). The median surgery time was 200 minutes (range, 57-444 minutes), and estimated blood loss was 50 mL (range, 10-3,500 mL). The median time to soft diet was 4 days (range, 2-8 days) and possible length of stay (hypothetical length of stay according to the discharge criteria) was 7 days (range, 4-22 days). The median total number of lymph nodes harvested was 23 (range, 8-71) and loop ileostomy was performed in 2 patients (4%). Six patients (11%) developed postoperative complications: 2 patients with anastomotic leakages, 1 with bladder leakage, and 3 with ileus. There was no mortality within 30 days.
Conclusion:
The present study shows that the presence of a SEMS does not compromise the laparoscopic approach. Laparoscopic resection following stent insertion for obstructing left-sided colon cancer could be performed with a favorable safety profile and short-term outcome. Large-scale comparative studies with long-term follow-up are needed to demonstrate a significant benefit of this approach.
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KEYWORD
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Colonic neoplasms, Stents, Laparoscopy
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