Comparison and short-term outcomes between hand-assisted laparoscopic surgery and conventional laparoscopic surgery for anterior resections of left-sided colon cancer

• Published in: International journal of colorectal disease 2010-08, Vol.25 (8), p.975-981
• Main Authors: Yun, Hae Ran, Cho, Yong Kwon, Cho, Yong Beom, Kim, Hee Cheol, Yun, Seong Hyeon, Lee, Woo Yong, Chun, Ho-Kyung
• Format: Article
• Language: English
• Subjects: Care and treatment; Colon cancer; Colonic Neoplasms - surgery; Comparative analysis; Demography; Disease-Free Survival; Female; Gastroenterology; Hepatology; Humans; Internal Medicine; Laparoscopic surgery; Laparoscopy; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patient outcomes; Perioperative Care; Proctology; Surgery; Time Factors; Treatment Outcome
• ISSN: 0179-1958; 1432-1262
• DOI: 10.1007/s00384-010-0948-z

Background Hand-assisted laparoscopic surgery has been introduced as an alternative to conventional laparoscopic surgery. This study compared the efficacies and short-term clinical outcomes between hand-assisted laparoscopic anterior resection (HAL-AR) and conventional laparoscopic anterior resection (CL-AR) for treating left-sided colon cancer. Materials and methods We retrospectively analyzed 248 patients who underwent anterior resection for colon cancer (118 HAL-AR and 128 CL-AR) between May 2000 and December 2006. The collected data included the perioperative and short-term oncologic outcomes. Results There were no significant differences between the HAL-AR and CL-AR groups, except for the operation time and the size of the primary tumor. The operation time of the HAL-AR group was significantly shorter than that of the CL-AR group ( p  = 0.004), and the size of the primary tumor in the HAL-AR group was significantly larger than that of the CL-AR group ( p  = 0.019). The operating time of the HAL-AR group reached an earlier mean plateau than did that of the CL-AR group. Before and after reaching the plateau, there were no differences in the perioperative results between the two groups. The operating time for the HAL-AR group was significantly shorter than that of the CL-AR group after reaching a plateau ( p  = 0.012). The short-term outcomes for both groups were similar in terms of survival and recurrence ( p  = 0.996 and p  = 0.476, respectively). Conclusion Hand-assisted laparoscopic anterior resection has a shorter operative time than does CL-AR and is more successful than CL-AR for resecting larger tumors, while both procedures result in similar short-term oncologic outcomes. Hand-assisted laparoscopic anterior resection is thought be a comparable operative technique for anterior resection of left-sided colon cancer.