Comparison of the overall stress during large bowel operations in senior patients (laparoscopy versus open surgery)
Authors:
Robert Hvižď 1; Zdeněk Krška 1; Jan Kvasnička 2
Authors place of work:
Univerzita Karlova v Praze, 1. lékařská fakulta, I. chirurgická klinika VFN
1; Univerzita Karlova v Praze, 1. lékařská fakulta, Trombotické centrum VFN
2
Published in the journal:
Čas. Lék. čes. 2012; 151: 201-207
Category:
Original Article
Summary
Background.
Colorectal surgery particularly as a treatment option for colorectal cancer comprises considerable and ever expanding spectrum of surgical procedures. Seniors (over 65 years of age) form the majority of patients operated for benign or malignant colon disease. High age in general poses one of the significant risks of the operation. The study analyses overall stress caused to patients by laparoscopy and laparotomy surgical procedures.
Methods.
Literature analysis of surgical stress in patients and prospective study of our patients’ data collected over the period of four years. Comparable indicators: objectification of pre-operative stress and risks, per-operative cardiac and circulatory parameters, course of the lesion healing process, laboratory reactions of acute phase proteins, morbidity and lethality related to the surgery treatment.
Results.
Comparable results of tissue response examinations demonstrated no fundamental difference between laparoscopic and laparotomic operations performed on otherwise healthy younger individuals. Laparoscopic surgery, however, appears to be fully appropriate treatment modality in majority of patients suffering from colorectal disease, even in senior age. In advanced or complicated stages of the disease the open-section surgery still remains more efficient.
Conclusion.
Age itself cannot be generally denoted as a fundamental risk factor. Co-morbid conditions, however, represent considerable risk, especially in high age patients. Laparoscopic surgery may well be applied even in senior age patients with no contra-indications. Yet, its application requires perfectly mastered laparoscopic technique and rational approach. Success of the operation in high-risk patients depends on close interdisciplinary cooperation, especially with anaesthetists.
Key words:
colorectal cancer, laparoscopy vs open surgery, perioperative response, senior age.
Zdroje
1. Krška Z, a kol. Miniinvazivní intervenční medicína. Praha: Triton 2001.
2. Krška Z, Šváb J, Schmidt D. Laparoskopická a laparotomická kolorektální chirurgie, Miniinvazivní přístup v řešení chorob GIT. Ostrava 2008, přednáška + sborník.
3. Bianchi PP, Ceriani C, Montorsi M. Laparoscopic surgery of colon cancer. State of art and literature review. Ann Ital Chir 2006; 77(4): 289–294.
4. Araujo SE, de Paris Caravatto PP, de Campos FG, da Silva e Sousa AH Jr, Nahas SC, Kiss DR, Cecconello I. Colorectal cancer among patients aged 75 years or over. Hepatogastroenterology 2007; 54(74): 427–430.
5. Brzešková R, Frýba V, Chrz K, Krška Z, Kvasnička J. Prodloužená profylaxe tromboembolické nemoci u pacientů po chirurgické resekci kolorekta pro malignitu. Rozhledy v chirurgii 2009; 88(11): 642–648.
6. Martínek L, Dostalík J, Vávra P, Guňková P, Guňka I. Implementace skórovacího systému POSSUM pro objektivizaci morbidity laparoskopických operací kolorekta. Rozhl Chir 2008; 87(1): 26–31.
7. Dostalík J, Martínek L, Vávra P, Anděl P, Guňková P, Guňka I. Laparoskopická kolorektální chirurgie pro karcinom – zhodnocení vlastního souboru. Rozhl Chir 2006; 85: 35–40.
8. Martínek L, Dostalík J, Vávra P, Anděl P, Guňková P, Guňka I., Jalůvka F. Laparoscopic colorectal surgery in high-risk patients, Book of Abstracts 12th International Congress of the E.A.E.S. Barcelona, Spain, 9.–12. 6. 2004; 159.
9. Škrovina M, Bartoš J, Czudek S, Soumarová R, Adamčík L. Kolorektální karcinom – zhodnocení krátkodobých výsledků laparoskopické resekce u 350 pacientů. Čas Lék čes 2006; 145: 874–878.
10. Lezoche E, Feliciotti F, Paganini AM, Guerrieri M, De Sanctis A, Minervini S, Campagnacci R. Laparoscopic vs open hemicolectomy for colon cancer. Surg Endosc 2002; 16(4): 596–602. Epub 2002 Jan 9.
11. Franks PJ, Bosanquet N, Thorpe H, Brown JM, Copeland J, Smith AM, Quirke P, Guillou PJ. CLASICC trial participants: hort-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial). Br J Cancer 2006; 95(1): 6–12. Epub 2006 Jun 6.
12. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM. COlon cancer Laparoscopic or Open Resection Study Group (COLOR): Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 2005; 6(7): 477–484.
13. Boller AM, Nelson H. Colon and rectal cancer: laparoscopic or open? Clin Cancer Res 2007; 13(22 Pt 2): 6894s–6896s.
14. Bonjer HJ, Hop WC, Nelson H, Sargent DJ, Lacy AM, Castells A, Guillou PJ, Thorpe H, Brown J, Delgado S, Kuhrij E, Haglind E, PĆhlman L. Laparoscopically assisted vs open colectomy for colon cancer: a meta-analysis., Transatlantic Laparoscopically Assisted vs Open Colectomy Trials Study Group. Arch Surg 2007; 142(3): 298–303.
15. Law WL, Chu KW, Tung PH. Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg 2002; 195(6): 768–773.
16. Law WL, Lee YM, Choi HK, Seto CL, Ho JW. Impact of laparoscopic resection for colorectal cancer on operative outcomes and survival. Ann Surg 2007; 245(1): 1–7.
17. Lezoche E, Feliciotti F, Guerrieri M, Paganini AM, De Sanctis A, Campagnacci R, D‘Ambrosio G. Laparoscopic versus open hemicolectomy. Minerva Chir 2003; 58(4): 491–502, 502–507.
18. Martel G, Boushey RP. Laparoscopic colon surgery: past, present and future. Surg Clin North Am 2006; 86(4): 867–897.
19. Veldkamp R, Gholghesaei M, Bonjer HJ, Meijer DW, Buunen M, Jeekel J, Anderberg B, Cuesta MA, Cuschierl A, Fingerhut A, Fleshman JW, Guillou PJ, Haglind E, Himpens J, Jacobi CA, Jakimowicz JJ, Koeckerling F, Lacy AM, Lezoche E, Monson JR, Morino M, Neugebauer E, Wexner SD, Whelan RL. European Association of Endoscopic Surgery (EAES): Laparoscopic resection of colon Cancer: consensus of the European Association of Endoscopic Surgery (EAES). Surg Endosc 2004; 18(8): 1163–1185. Epub 2004 Jun 23.
20. Yasunaga H, Matsuyama Y, Ohe K. Japan Surgical Society. Effects of hospital and surgeon volumes on operating times, postoperative complications, and length of stay following laparoscopic colectomy. Surg Today 2009; 39(11): 955–961. Epub 2009 Nov 1.
Štítky
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistČlánok vyšiel v časopise
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