Our Summary

This research paper is a comprehensive review of nine studies, published between 2007 and 2016, that compared two types of surgery for colorectal cancer: hand-assisted laparoscopic surgery (HALS) and conventional laparoscopic surgery (LAS). Over 1300 patients were included in these studies.

The review looked at various aspects of the surgeries, including how long they took, how much blood was lost, how long the incisions were, whether blood transfusions were needed, how many lymph nodes were removed, and whether the surgery had to be converted to a more traditional, open surgery. It also looked at what happened after surgery, including how long people stayed in the hospital, when they first passed gas and had a bowel movement, and whether there were complications like infections, bleeding, or the need for another surgery. Lastly, it looked at how long people lived after surgery.

The main finding was that the two types of surgery were pretty similar across all these aspects. The only difference was that the incisions were longer in the hand-assisted surgeries. So, for people with colorectal cancer, the study suggests that both types of surgery could be good options, with similar outcomes.

FAQs

  1. What aspects of the surgeries were compared in the reviewed studies?
  2. What was the main difference found between hand-assisted laparoscopic surgery (HALS) and conventional laparoscopic surgery (LAS) for colorectal cancer?
  3. What does the study suggest about the outcomes of hand-assisted laparoscopic surgery (HALS) and conventional laparoscopic surgery (LAS) for colorectal cancer?

Doctor’s Tip

A doctor might tell a patient that laparoscopic surgery is less invasive than traditional open surgery, which can lead to a quicker recovery time, less pain, and smaller scars. They may also explain that with laparoscopic surgery, there is a lower risk of complications such as infections and blood loss. Additionally, they may advise the patient to follow their post-operative care instructions closely to ensure the best outcome.

Suitable For

Patients who are typically recommended for laparoscopic surgery include those with colorectal cancer, gallbladder disease, hernias, appendicitis, and certain gynecological conditions such as endometriosis or ovarian cysts. Additionally, patients who are considered to be good candidates for laparoscopic surgery are those who are generally healthy, have a lower risk of complications, and have smaller, less complex medical conditions that can be effectively treated with minimally invasive techniques. Consulting with a healthcare provider is essential to determine if laparoscopic surgery is the best option for a patient’s specific medical condition.

Timeline

Before laparoscopic surgery:

  • Patient meets with surgeon to discuss surgical options and potential risks and benefits
  • Patient undergoes pre-operative tests and evaluations
  • Patient may need to make lifestyle changes in preparation for surgery
  • Patient may be instructed to fast before surgery
  • Patient arrives at hospital or surgical center on the day of surgery

During laparoscopic surgery:

  • Patient is placed under anesthesia
  • Surgeon makes small incisions in the abdomen and inserts a laparoscope (a thin, lighted tube with a camera) to visualize the surgical area
  • Surgical instruments are inserted through additional small incisions to perform the procedure
  • Surgery is completed, and incisions are closed with sutures or surgical tape

After laparoscopic surgery:

  • Patient wakes up in the recovery room
  • Patient may experience pain, nausea, and grogginess
  • Patient is monitored for any complications or side effects of anesthesia
  • Patient is encouraged to walk and move around to aid in recovery
  • Patient may need to stay in the hospital for observation or be discharged to recover at home
  • Patient may be prescribed pain medication and given instructions on wound care and activity restrictions
  • Patient follows up with surgeon for post-operative appointments and monitoring of recovery progress.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laparoscopic surgery for colorectal cancer include:

  1. What are the potential risks and complications associated with laparoscopic surgery?
  2. How long will the surgery take, and what is the expected recovery time?
  3. Will I need a blood transfusion during or after the surgery?
  4. How many lymph nodes will be removed during the surgery?
  5. What is the likelihood that the surgery will need to be converted to an open procedure?
  6. How long will I need to stay in the hospital after the surgery?
  7. When can I expect to have my first bowel movement and pass gas after the surgery?
  8. What are the potential long-term effects or complications after the surgery?
  9. How does the success rate and survival rate compare between hand-assisted laparoscopic surgery and conventional laparoscopic surgery for colorectal cancer?

By asking these questions, patients can gain a better understanding of the procedure, its potential outcomes, and make informed decisions about their treatment.

Reference

Authors: Zhang X, Wu Q, Hu T, Gu C, Bi L, Wang Z. Journal: J Laparoendosc Adv Surg Tech A. 2017 Dec;27(12):1251-1262. doi: 10.1089/lap.2017.0210. Epub 2017 Aug 16. PMID: 28813634