Laparoscopic colectomy

In colorectal surgery decreases postoperative ileus, time to ambulation, return to normal daily activities, time in hospital and decreases analgesic needs compared to conventional open surgery.

Postoperative length of stay 4 to 6 days.

Compared to open surgery results in a significant reduction of 30-day postoperative morbidity.

Equivalent to open colectomy as far as cancer recurrence in colon cancer patients.

No difference on 30-day mortality compared to open colectomy.

Conversion rate to open colectomy about 10% and secondary to obesity and inflammatory adhesions.

No difference in the exfoliation of cancer cells in peritoneal lavage before and after colon resection by comparing laparoscopic and open surgery.

Blood loss significantly lower in laparoscopic group than in open surgery group.

Reduced incidence in wound infections compared to open surgery.

Less impairment of lymphocyte proliferation and gut oxygen tension is less pronounced than in an open surgery group.

Technical limitations include lack of tactile feedback, difficulty in handling a large and mobile colon, need to ligate many large blood vessels, and need to operate in multiple areas of the abdomen.

Colectomy in elderly associated with mortality in 30% of patients within 3 months, and 40% of survivors have a significant decline in functional status.

In elderly undergoing colectomy half patients die by 12 months, and half of the survivors sustain functional decline.

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