Our Summary

This study looks at the use of a type of surgery called laparoscopic colectomy (LC), which is a less invasive approach to removing part of the colon. The researchers were interested in whether this type of surgery is being used more often in emergency situations, and if it leads to longer hospital stays or higher death rates compared to the more traditional open colectomy (OC), which involves a larger incision.

The study used data from the National Trauma Data Bank from 2008-2015, and included adult patients who had either LC or OC. The results showed that the number of patients having LC increased by 21 times over the study period, with about 119 out of every 10,000 trauma patients having this procedure. The most common procedure was a type of LC called a laparoscopic right hemicolectomy.

The researchers also found that patients who had LC had slightly less severe injuries on average, but there was no difference in the length of hospital stay or death rates between the two groups. This suggests that LC could be a good option for certain trauma patients. However, more research is needed to confirm these findings and to work out which patients would benefit most from LC.

FAQs

  1. What is a laparoscopic colectomy and how does it compare to a traditional open colectomy?
  2. Has the use of laparoscopic colectomy increased over time, particularly in emergency situations?
  3. Does the use of laparoscopic colectomy result in longer hospital stays or higher death rates compared to traditional open colectomy?

Doctor’s Tip

A helpful tip a doctor might give a patient about laparoscopic colectomy is to ensure they follow their post-operative care instructions carefully, including taking any prescribed medications, attending follow-up appointments, and gradually increasing activity levels as advised by their healthcare team. It is also important for patients to follow a healthy diet and stay hydrated to support their recovery process. Additionally, patients should communicate any concerns or unusual symptoms to their healthcare provider promptly.

Suitable For

Patients who are typically recommended laparoscopic colectomy include those with conditions such as colon cancer, diverticulitis, inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease), and other benign or malignant tumors of the colon. Additionally, patients who are considered high-risk for complications from traditional open surgery, such as those who are elderly or have multiple comorbidities, may also be good candidates for laparoscopic colectomy. Ultimately, the decision to recommend laparoscopic colectomy will depend on the individual patient’s specific condition and circumstances, and should be made in consultation with a surgeon.

Timeline

Before laparoscopic colectomy:

  1. Patient is diagnosed with a condition requiring surgery on the colon.
  2. Patient undergoes preoperative evaluation and testing.
  3. Surgery is scheduled and patient receives instructions on preoperative preparation.
  4. Patient arrives at the hospital on the day of surgery and undergoes anesthesia.

During laparoscopic colectomy:

  1. Surgeon makes small incisions in the abdomen and inserts a laparoscope to view the colon.
  2. Diseased portion of the colon is removed using specialized instruments.
  3. Remaining parts of the colon are reconnected or a colostomy may be created.
  4. Surgery typically lasts around 2-3 hours.

After laparoscopic colectomy:

  1. Patient is monitored in the recovery room and then transferred to a hospital room.
  2. Pain medication is provided to manage postoperative pain.
  3. Patient begins a clear liquid diet and gradually transitions to solid foods as tolerated.
  4. Physical therapy may be initiated to aid in recovery.
  5. Patient is discharged from the hospital within a few days and instructed on postoperative care.
  6. Follow-up appointments are scheduled to monitor recovery and address any complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic colectomy include:

  1. What are the potential risks and complications associated with laparoscopic colectomy compared to open colectomy?
  2. How long is the recovery time after laparoscopic colectomy?
  3. Will I need any special dietary or lifestyle changes after the surgery?
  4. How experienced are you in performing laparoscopic colectomy procedures?
  5. Are there any specific criteria or conditions that make me a better candidate for laparoscopic colectomy over open colectomy?
  6. What is the success rate of laparoscopic colectomy in treating my specific condition?
  7. Will I need any additional follow-up appointments or tests after the surgery?
  8. Are there any long-term side effects or considerations I should be aware of after undergoing laparoscopic colectomy?
  9. How soon can I return to normal activities, such as work or exercise, after laparoscopic colectomy?
  10. Are there any alternative treatment options to consider before deciding on laparoscopic colectomy?

Reference

Authors: Grigorian A, Pigazzi A, Nguyen NT, Schubl SD, Joe V, Dolich M, Lekawa M, Nahmias J. Journal: Updates Surg. 2019 Mar;71(1):105-111. doi: 10.1007/s13304-018-0588-3. Epub 2018 Aug 24. PMID: 30143986