Laparoscopic colorectal resection versus open colorectal resection in octogenarians: a systematic review and meta-analysis of safety and efficacy

Abstract Octogenarians are more often viewed as high-risk surgical candidates. This increased risk is attributed to an age-related decline in physical function and reserve capacity coupled with the presence of various underlying diseases. There are no current guidelines or consensus on the optimal treatment strategy for this cohort of complex patients. The aim of this systematic review and meta-analysis was to compare the efficacy and safety of laparoscopic colorectal resection versus open colorectal resection in octogenarians. The meta-analysis was conducted following all aspects of the Cochrane Handbook for Systematic Reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic literature review was carried out using the following databases: MEDLINE, Embase, PubMed, the Cochrane Library, Google Scholar and OVID. Only studies comparing outcome of laparoscopic and open colorectal resections in the elderly population (≥80 years) were selected. The data collected included the patient demographics, interventions, observed outcome and sources of bias. When performing the statistical analysis, we used the odds ratio for categorical variables and the weighted mean difference for continuous variables. The results of this systematic review and pooled analysis demonstrated the safety and potential benefits of laparoscopic colorectal resection in octogenarians. LC can reduce the length of hospital stay, intraoperative ...
Source: Techniques in Coloproctology - Category: Surgery Source Type: research

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AbstractBackgroundExploratory laparotomy (EL) has been the definitive diagnostic and therapeutic modality for operative abdominal trauma in the US. Recently, many trauma centers have started using diagnostic laparoscopy (DL) in stable trauma patients in an effort to reduce the incidence of non-therapeutic laparotomy (NL). We aim to evaluate the incidence of NL in the trauma population in the US and compare the outcomes between DL and NL.MethodsUsing ICD-9 codes, the National Trauma Data Bank (2010 –2015) was queried for patients undergoing any abdominal surgical intervention. Patients were divided into two groups: di...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Abstract BACKGROUND: Laparoscopy has been widely used in general surgical procedures, but total laparoscopic pancreaticoduodenectomy (TLPD) is still a complex and challenging surgery that is only performed in a small number of patients at a few large academic medical centers. Although the safety and feasibility of TLPD have been established, few studies have compared it with open pancreaticoduodenectomy (OPD) with regard to perioperative and oncological outcomes. Therefore, we carried out a meta-analysis to evaluate whether TLPD is superior to OPD. AIM: To compare the treatment outcomes of TLPD and OPD in ord...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
AbstractIntroductionLaparoscopic sleeve gastrectomy (LSG) is a widely accepted stand-alone bariatric operation. Data on adolescent patients undergoing LSG are limited. The aim of this study was to demonstrate that LSG is safe and effective for patients strictly under 18  years old with severe obesity.MethodsProspectively collected data from consecutive patients undergoing LSG were retrospectively analyzed. Patients with more than 1-year follow-up were included in the analysis for weight loss and comorbidity evaluation. Quality of life (QoL) was evaluated using the Short-Form 36 questionnaire.ResultsEighty-four patient...
Source: Obesity Surgery - Category: Surgery Source Type: research
ConclusionsIn summary, 3D laparoscopic rectal surgery appears to have advantages over 2D laparoscopic rectal surgery in terms of positive CRM and operation time; however, it is not better than 2D laparoscopic rectal surgery in terms of the conversion rate and postoperative complications.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
AbstractDevelopment of gastrojejunal stricture following Roux-en-Y gastric bypass (RYGB) leads to an increase in morbidity and adverse effects, such as abdominal pain, vomiting, aspiration pneumonia, and malnutrition. Up to 38.5% of patients will require revisional surgery for late anastomotic strictures despite conservative treatment. However, no previous studies focused on revisional robotic bariatric surgery due to strictures after RYGB have been reported. To evaluate our outcomes and assess the advantages of the robotic platform with regard to laparoscopic and open revisional procedures. University Hospital. We perform...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research
We herein present an innovative technique of laparoscopic posterior mesh rectopexy (LPMR) for full-thickness rectal prolapse and report the clinical outcomes in our institution. Ten consecutive patients who were treated with our latest LPMR technique using mesh with an anti-adhesion coating from June 2014 to May 2017 were retrospectively analyzed. All patients were women with a mean age of 63.6 years (range, 39 to 82 y). The median operative time and blood loss volume were 197.5 minutes (range, 156 to 285 min) and 0 mL (range, 0 to 152 mL), respectively. No perioperative complications occurred, ...
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Online Articles: Technical Reports Source Type: research
ConclusionsPostoperative complications adversely affected the prognosis in patients with resectable gastric cancer.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
AbstractPurposeMost elderly patients with colorectal cancer have comorbidities and reduced functional reserve, which may increase their risks of postoperative morbidity and mortality, and subsequently influence the treatment choice. Therefore, this study aimed to investigate the treatment choice and compare laparoscopic and open surgery in this setting.MethodsThis retrospective study evaluated 118 patients with colorectal cancer ( ≥ 85 years old between January 2007 and February 2018) to determine the influence of comorbidities on treatment choice, as well as the safety and feasibility of laparoscopic s...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
Abstract BACKGROUND: The number of bariatric procedures performed on complex, oxygen-dependent patients has increased. These patients often have other medical co-morbidities that can be improved after bariatric surgery; however, questions remain regarding their perioperative risk. OBJECTIVE: To assess the safety of bariatric surgery among oxygen-dependent patients, and to compare outcomes in this patient group after laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy. SETTING: University and private hospitals enrolled in the Metabolic and Bariatric Surgery Accreditation and Quali...
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - Category: Surgery Authors: Tags: Surg Obes Relat Dis Source Type: research
ConclusionsOn the basis of slight body weight loss and the absence of food residue observed in the postoperative endoscopy, NEWS appeared to be safe and feasible for gastric SMTs and to preserve function of the remnant stomach.
Source: Gastric Cancer - Category: Gastroenterology Source Type: research
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