SEARCH · PubMed Health

Results for “resectability”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources

PubMed1999

Prevalence and clinical importance of Helicobacter pylori infection in patients after partial gastric resection for peptic ulcer disease. A prospective evaluation of Helicobacter pylori infection on 50 resected patients compared with matched nonresected controls.

UNLABELLED: There have been only a few surveys on the prevalence of persistent Helicobacter pylori (Hp) infection in patients who have undergone surgery for peptic ulceration. The aim of the study was to evaluate the prevalence and clinical importance of Hp infection after partial gastric surgery due to peptic ulcer disease. METHODS: We examined 50 patients who had partial gastric resection for peptic ulcer disease and years later underwent upper gastrointestinal (GI) endoscopy. 50 controls matched with respect to indication for GI endoscopy, age and gender were also studied. Three specimens from the fundus of gastric remnant were examined for Hp infection (histology and rapid urease test). The prevalence of Hp infection and pathology findings were compared between the two groups using chi-square statistics. RESULTS: 32 men and 18 women were examined (40 x BII, 10 x BI). The prevalence of Hp infection was 38% in the resected group compared to 60% in the control group (p = 0.015). We found a significant association (p = 0.0004) between Hp infection and endoscopic findings in the control group but not in the group of partially resected patients (p = 0.66). CONCLUSION: The prevalence of Hp infection in hospitalized patients with partial gastric resection is significantly lower than in matched controls. Hp infection does not play a significant pathogenic role in recurrent ulcer after partial gastric resection in these patients.

Adult↗

PubMed2000

[Long-term therapeutic effects of extended radical resection and radical resection of cancer of cardia and stomach fundus].

OBJECTIVE: To study the best range of radical resection in the treatment of cancer of the cardia and fundus of stomach. METHODS: 418 patients with cancer of the cardia and fundus of stomach underwent radical resection. Of them 192 were treated by extended radical resection (extended group), and 226 by radical resection (radical group). The 5-year and 10-year survival rates were followed up and compared in the two groups. RESULTS: Analysis failed to demonstrate significant difference between the two operations for TNM stage I and II (P > 0.05). For stage III, however, the 5-year and 10-year survival rates in the extended group increased by 14.2% and 15.9% as compared with those in the radical group (P < 0.05). The two groups survival rates were similar for stage IV (P > 0.05). CONCLUSIONS: To completely clean the lymph nodes of splenic hilus and artery and improve long-term survival rate, extended radical resection including spleen and body and tail of the pancreas should be recommended for stage III patients with cancer of the cardia and fundus of stomach when their serosa was involved or lymph node metastasis took place.

Cardia↗

PubMedDate not supplied

Combination therapy of resection and intraoperative radiation for patients with carcinomas of extrahepatic bile duct and ampulla of Vater: prognostic advantage over resection alone?

BACKGROUND/AIMS: To investigate the therapeutic efficacy of intraoperative radiation for carcinomas of the bile duct and ampulla of Vater. METHODOLOGY: Postoperative morbidity, mortality and survival of patients undergoing surgical resection of ampullary cancer (n = 19) and bile duct cancer (n = 28) were retrospectively compared between two groups with and without intraoperative radiation. RESULTS: Background items (age, gender, preoperative laboratory data, operative time and bleeding volume, tumor stage) did not differ significantly between the two groups. The predominant postoperative complication was leakage of pancreatic juice, which occurred in similar rates in both groups. No significant differences were noted in the 3-year survival rates between the resection plus intraoperative radiation group and resection alone group (60.0% (n = 5) vs. 50.1% (n = 13) for ampullary cancer; 0% (n = 4) vs. 27.1% (n = 24) for bile duct cancer, respectively). The main causes of recurrence were distant metastasis for ampullary cancer and microscopic residue of carcinoma for bile duct cancer. CONCLUSIONS: The combination of intraoperative radiation and resection may add no significant benefit to patients with ampullary and bile duct cancer when compared with resection alone.

Aged↗

PubMed2003

[Duodenum-preserving total pancreatic head resection and pancreatic head resection with segmental duodenostomy].

A duodenum-preserving pancreatic head resection (DPPHR) was first reported by Beger et al. in 1980. However, its application has been limited to chronic pancreatitis because of it is a subtotal pancreatic head resection. In 1990, we reported duodenum-preserving total pancreatic head resection (DPTPHR) in 26 cases. This opened the way for total pancreatic head resection, expanding the application of this approach to tumorigenic morbidities such as intraductal papillary mucinous tumor (IMPT), other benign tumors, and small pancreatic cancers. On the other hand, Nakao et al. reported pancreatic head resection with segmental duodenectomy (PHRSD) as an alternative pylorus-preserving pancreatoduodenectomy technique in 24 cases. Hirata et al. also reported this technique as a new pylorus-preserving pancreatoduodenostomy with increased vessel preservation. When performing DPTPHR, the surgeon should ensure adequate duodenal blood supply. Avoidance of duodenal ischemia is very important in this operation, and thus it is necessary to maintain blood flow in the posterior pancreatoduodenal artery and to preserve the mesoduodenal vessels. Postoperative pancreatic functional tests reveal that DPTPHR is superior to PPPD, including PHSRD, because the entire duodenum and duodenal integrity is very important for postoperative pancreatic function.

Adenocarcinoma, Mucinous↗

PubMedDate not supplied

Analysis of the prognostic factors for liver metastasis of gastric cancer after hepatic resection: a multi-institutional study of the indications for resection.

BACKGROUND/AIMS: The number of reports of hepatic resection for metastatic gastric cancer is very small. The outcome and indications of hepatic resection for metastatic gastric cancer remains unknown. METHODOLOGY: A multi-institutional study was made. Thirty-six patients who underwent a hepatic resection for liver metastasis of gastric cancer with no residual tumor were included in this study. The clinicopathological factors were examined as prognostic factors by multivariate analyses. Thirty patients had recurrence and the recurrence pattern and risk factors for extrahepatic recurrence was examined. RESULTS: The overall survival rate was 64% at 1 year, 43% at 2 years, 26% at 3 years 26% at 5 years, and 26% at 10 years after hepatectomy. Multivariate analysis showed that lymphatic invasion, venous invasion of cancer cells of primary gastric cancer and the number of the liver metastasis (> 3) were independent poor prognostic factors after hepatic resection. The most common recurrence pattern was intrahepatic recurrence in 22 patients (73%). The risk factors for extrahepatic recurrence was serosal invasion, lymph node metastasis of primary gastric cancer, stage, and curability of operation. CONCLUSIONS: Hepatic resection for liver metastasis should be attempted in case primary gastric cancer has neither lymphatic invasion nor venous invasion. The most common recurrent site was the liver. In patients with advanced gastric cancer, having neither serosal invasion nor lymph node metastasis, who underwent a less curative operation, the intra-hepatic recurrence would be expected. Thus, aggressive adjuvant chemotherapy through the hepatic artery may improve the survival after hepatectomy in these patients.

Aged↗

PubMed2003

[A case of curative resection of local recurrence after abdominosacral resection of recurrent rectal cancer based on the diagnosis of PET/CT fusion images].

A 76-year-old male with local recurrence after abdominosacral resection of recurrent rectal cancer was admitted to our hospital. Computed tomography (CT) and magnetic resonance imaging (MRI) indicated a recurrent tumor at the back of the prostate and seminal vesicles up to the resected sacral (S3) stump. However, positron emission tomography (PET)/CT fusion images showed no 18F-2-fluoro-2-deoxy-D-glucose (FDG) uptake at the pre-sacral region, which suggested postoperative scarring of the tissue. Based on the PET/CT diagnosis, we performed abdominoperineal en bloc resection of the recurrent tumor with bladder, seminal vesicles, prostate, internal obturator muscle, ischial spine, and gluteal muscle without resection of the sacrum. Specimen revealed no circumferential resection margin involvement by tumor on pathologic examination. The patient was discharged from the hospital on postoperative day 23 without major complications.

Aged↗

PubMedDate not supplied

Inferior head resection of the pancreas and cyst resection for choledochal cyst with chronic calcifying pancreatitis.

We report inferior head resection of the pancreas and cyst resection for congenital choledochal cyst with an anomalous arrangement of pancreaticobiliary duct and chronic calcifying pancreatitis. A 42-year-old man was admitted to the National Cancer Center Hospital East complaining of back pain. Contrast-enhanced computed tomography showed marked dilatation of the bile duct and multiple pancreatic stones in the main pancreatic duct. Endoscopic retrograde cholangiopancreatography demonstrated pancreatic stones in the dilated main pancreatic duct. The patient underwent cyst excision, inferior head resection of the pancreas, hepaticojejunostomy and lateral pancreaticojejunostomy. The postoperative course was uneventful. This procedure relieved the back pain. Choledochal cyst with anomalous arrangement of the pancreaticobiliary duct is frequently associated with acute pancreatitis. Inferior head resection of the pancreas removed the common channel which could be the cause of relapsing pancreatitis. Thus, inferior head resection can play a role in the management of choledochal cyst with chronic pancreatitis.

Adult↗

PubMed2005

Extended right hepatectomy with total caudate lobe resection and biliary tree resection for a large colorectal liver metastasis involving both the right and left hepatic lobes and the umbilical fissure: a case report.

Very large right-sided liver tumors may grow up to the base of the umbilical fissure and involve the left hepatic duct and can occasionally reach the bile duct confluence. This kind of involvement has often been considered a contraindication to resection. We report a patient who presented with a large hepatic metastasis from colorectal cancer that reached the umbilical fissure and involved the left hepatic duct just above the bile duct confluence. An extended right hepatectomy including complete resection of caudate lobe was performed. We resected the left and common hepatic ducts, as well as both the entire hepatic and the proximal third of common bile duct. A long jejunal limb Roux-en-Y (45 cm) single-layer left intrahepatic hepaticojejunostomy was constructed. She is still well 14 months postoperatively. To the best of our knowledge, this is the first report of such a procedure employed for the treatment of a liver metastasis from colorectal cancer. Extended right hepatectomy including complete caudate lobe resection can be feasible even when the majority of the extrahepatic biliary system needs to be resected. Our approach probably offers the only chance to prevent early death from liver failure in these patients.

Anastomosis, Roux-en-Y↗

PubMed2005

[Comparison of long- term efficacy between preoperative radiotherapy or radiochemotherapy followed by lower-anterior resection and Miles abdominoperineal resection in patients with low rectal cancer].

OBJECTIVE: To compare the long-term efficiency between preoperative radiotherapy or radiochemotherapy followed by lower-anterior resection and abdominoperineal resection (APR) for lower and locally advanced rectal cancer. METHODS: From January 1983 to December 2000, 157 consecutive patients suffering from lower rectal cancer were enrolled in the study, which included 69 cases of clinical stage II and 88 cases of stage III respectively. All patients were divided in to three groups. Patients in group A (n=52) received preoperative radiotherapy with a total dose of 35-45 Gy within 4-5 weeks plus preoperative chemotherapy with 5-fluorouracil (5- FU) followed by lower-anterior resection; patients in group B (n=51) received radiotherapy followed by lower-anterior resection; patients in group C (n=54) received APR only. Clinical data of all patients were reviewed retrospectively. RESULTS: The follow-up rate was 91.7%. The 5- year survival rate was higher in group A (71.1%) than those in group B (47.1%) and group C (42.6%)(P< 0.05). The tumor- free survival rate was higher in group A (61.5%) than those in group B (37.3%) and group C (35.2%)(P< 0.05). The local recurrence rate was 13.5%, 15.7% and 11.1% in group A, B and C respectively, there was no significant difference in recurrence rate among three groups (P> 0.05). The distant metastasis rate was lower in group A (23.1%) than those in group B (49.0%) and group C (46.3%)(P< 0.05), but there was no significant difference in distant metastasis rate between group B and group C. CONCLUSIONS: The combined preoperative radiochemotherapy followed by lower-anterior resection can improve the 5-year survival rate and tumor-free survival rate, and decrease distal metastasis rate.

Adult↗

PubMed2006

[Modern radical resection for lung cancer; a critique on the video-assisted radical resection].

The modern radical resection for the lung cancer consists of the parenchymal lung resection at least by tumor-bearing lobe and hilar/mediastinal lymph node dissection. For minimally invasive intent, the curative resection is being performed under video-thoracoscopy. The relative advantage over the conventional procedure under thoracotomy has yet to be defined in terms of operative indicators, postoperative pain, safety, cost, and so on. No previous study has ever clearly described the significant difference between these 2 procedures. The present thoracotomy-based radical resection has been fully down-sized together with advanced instrumentations, and the perioperative parameters between 2 procedures remained minimal. The evidence-based advantage of video-assisted radical resection needs to be addressed. Since their differences are solely concerned about the route of the approach into the thoracic cavity, the oncological difference reasonably does not seem to exist.

Humans↗

PubMed1980

[Quantitative investigations of the structure and function of the intestinal mucosa in endoscopically obtained biopsy material. Findings in patients with coeliac disease, patients with partially resected small intestine in Crohn's disease and in patients with small intestine resection for other reasons (author's transl)].

During an endoscopy of the upper gastrointestinal tract, biopsy material of the small intestine was obtained and structure and function of the small intestinal mucosa was investigated. The data were then compared with published results, gained by normally performed blind biopsy techniques. For that the findings of three groups of patients (1. patients with coeliac disease [9], 2, patients with ileal resection due to ileitis terminalis Crohn [9], 3. patients with partially resection of the small intestine due to other reasons [4]) were compared with healthy controls (10). The results indicate that obtaining small intestinal biopsy material endoscopically enables a valid characterization of differentiated properties of the small bowel mucosa. The data of the patients with coeliac disease are in complete agreement with the criteria of this syndrome, published in the literature. On the other hand the results of the group with partial resection of the small intestine resection (without chronic inflammatory bowel disease) show all signs of adaptive mucosal hyperplasia of the remaining small intestine. However, patients with Crohn's disease did not show any adaptive response to small bowel resection.

Adaptation, Physiological↗

PubMed1995

[Surgical therapy of rectal prolapse using rectopexy and resection. Effect of resection treatment on postoperative constipation and sphincter muscle function--a follow-up study of 112 patients].

Between 1985 and 1991, 112 patients underwent posterior abdominal rectopexy (n = 59 Ivalon sponge, n = 53 Vicryl-rectopexy) for complete rectal prolapse. The follow-up period was 3 months to 9 1/2 years. 25 patients with severe constipation and rectal prolapse were treated by rectopexy combined with colectomy (left colectomy n = 18, sigmoidectomy n = 3, ileo-sigmoidostomy n = 4). Left colectomy combined with Ivalon or Vicryl-rectopexy does not seem to increase operative and postoperative morbidity but tends to diminish constipation in 84% of patients. There were no complications attributable to bowel resection or anastomosis. Following abdominal rectopexy without resection constipation was reduced 7.5% only, the bowel function was unchanged in 69% and obstipation was improved after the operation in 23%. In the group of patients without evident constipation (n = 74) treated with synchrone resection has no benefit with regard to the new occurred constipation, recurrence prolapse and continence ability. Infection around the prosthesis developed in 1.5% in the resection group, and in 2.1% in the rectopexy alone group. The prolapse recurrence rate was 2.6%. Conclusion. Resection in conjunction with abdominal rectopexy tends to diminish postoperative constipation does not seem to increase operative morbidity, and is indicated in patients with constipation only.

Adult↗

PubMedDate not supplied

Carcinoma of the pancreatic head area. Therapy: resectability and surgical management of resectable tumors.

Surgical resection is being increasingly performed for carcinomas of the area of the head of the pancreas with curative intent. Pre-and intraoperative assessment of the site of origin and the stage of the lesion is of the utmost importance for a more favorable prognosis of non pancreatic forms and for a better evaluation of long term results of treatment adopted. Staging of non pancreatic periampullary tumors is usually very precise since they are most often shown to be resectable on laparotomy. Surgical resection by pancreaticoduodenectomy is the treatment of election based on good long term results. To the contrary, problems involved in the carcinoma of the head of the pancreas are non negligible. Some aspects related to the criteria of resectability of these tumors (diameter of primary lesion, infiltration of adjacent organs and large vessels, lymph node involvement) are discussed. How extensive pancreatic resection (subtotal, total or regional pancreatectomy) should be, is still a debated subject. In fact, it is not directly proportional to an improvement in prognosis. Complementary treatments directed to the improvement of the disappointing results at present achieved with surgery alone, are desirable.

Humans↗

PubMed1996

[Surgical resection of colorectal liver metastases: Gold standard for solitary and radically resectable lesions].

From 1960 to 1993, a total of 1.766 patients with liver metastases from colorectal carcinoma was recorded. Five-hundred-and-eight patients (28.8%) underwent hepatic resection which was performed with curative intent in 473 patients (26.8%). 30-day mortality in this group was 4.5%, being 2.6% (4 out of 155) since 1990. Significant morbidity was observed in 16% of patients with a decrease to 7% for the last 4 years. A 99.5 percent follow-up until January 1, 1996, was achieved. Excluding operative mortality there are 376 patients with "potentially curative" initial liver resection, and 65 corresponding patients with minimal macroscopic (n = 19) or microscopic (n = 46) residual disease. The latter group demonstrated a poor prognosis with median and maximum survival times of 14.8 and 56 months, respectively. Among the 376 patients having potentially curative resection the actuarial five, ten, and twenty year survival was 39 +/- 3, 26 +/- 5 and 21 +/- 13 percent, respectively. Tumor-free survival was 34 +/- 3 percent at 5 years. In the univariate analysis, the following factors were associated with decreased crude survival: Presence and extent of mesenteric lymph node involvement (p = 0.0001), poor grading of the primary tumor (p = 0.008), synchronous diagnosis of metastases (p = 0.004), satellite metastases (p < 0.0001), an increasing metastasis diameter (p < 0.0001), preoperative CEA elevation (p = 0.0002), a resection margin of less than 1 cm (p = 0.018), extrahepatic disease (p = 0.02), non-anatomical procedures (p = 0.008), and an operative blood loss exceeding 2.000 ml (p = 0.02). With respect to disease-free survival, extrahepatic disease (p = 0.09) failed to achieve statistical significance, while patients with colon cancer and with delayed resection of synchronous metastases did significantly better than those with rectal cancer (p = 0.02) and with a simultaneous procedure (p = 0.04), respectively. Multiplicity and bilobar involvement did not affect prognosis. Similarly, no significant predictive value of an increasing number of metastases (1-3 vs > or = 4) on either overall (p = 0.35) or disease free survival (p = 0.55) was found after a radical excision of all detectable disease. Using Cox's multivariate regression analysis, presence of satellite metastases, anatomical vs non-anatomical approach, primary tumor grade and diameter of the largest metastasis all independently affected both crude and tumor-free survival (p < 0.05). With respect to survival, this was complemented by the margin of clearance (0.05 < p < 0.1), while for disease-free survival primary tumor site and time of metastasis diagnosis had some additional influence. Twenty-six patients with R0-reresection of the liver, and 32 patients with radical excision of extrahepatic recurrent disease had a subsequent 5-year survival of 57 +/- 15 percent and 32 +/- 12 percent, respectively. This confirms the effectiveness of a close follow-up policy.

Adult↗

PubMed2000

Transurethral vaporization-resection of the prostate versus standard transurethral prostatectomy: comparative changes in histopathological features of the resected specimens.

OBJECTIVES: Transurethral vaporization resection of the prostate (TUVRP) is a recent modification of the standard transurethral resection of the prostate (TURP). TUVRP uses a band electrode coupled to a high electrocuting energy to achieve simultaneous resection, vaporization and coagulation of the prostate. We evaluated the histopathological resection specimens of patients treated with TUVRP to see whether the higher energy used will result in thermal artifacts that will interfere with the pathological evaluation of the prostate, and compared the results to TURP specimens. MATERIAL AND METHODS: The histopathological specimens of 50 patients that underwent TUVRP or TURP were reviewed. Artifactual pathological patterns that were identified in the specimens included: abnormal cellular orientation and spindling, artifactual cellular detachment from the underlying basement membrane, atypical cytological changes or areas of stromal coagulative necrosis. Each identified pattern was awarded 1 point. The severity of cautery artifact was graded into mild, moderate or severe according to the sum of points in each specimen. RESULTS: Mild cautery artifact changes were noted in 1 patient who underwent TURP. Moderate changes were noted in 21 patients in each TURP and TUVRP groups while severe changes were noted in 4 and 3 patients undergoing TUVRP and TURP respectively. There were no statistically significant differences between the groups with regard to the severity of the cauterization- induced changes. CONCLUSIONS: The quality of histopathological specimens produced by TUVRP is similar to the standard TURP. It seems that the higher energy use in electrovaporization technique does not result in greater thermal injury to the tissues possibly because of the cooling effect of the irrigation fluids used intraoperatively.

Artifacts↗

PubMed2006

Transurethral electrovapor resection versus standard transurethral resection treatment for a large prostate: a 2-year follow-up study conducted in Taiwan.

INTRODUCTION: Those patients featuring a large prostate and undergoing transurethral resection typically face a longer duration of surgery, they have a higher degree of hemorrhage and a higher irrigant volume required for the procedure, and they tend to reflect a higher incidence of morbidity than is the case for a small prostate. We report on the relative safety and efficacy of transurethral electrovapor resection of the prostate (TUVRP) as compared with standard transurethral resection of the prostate (TURP) for Taiwanese patients having a prostate size >50 ml. PATIENTS AND METHODS: Seventy-six symptomatic benign prostatic hyperplasia patients featuring a prostate size >50 ml were randomized and underwent either TUVRP using wedge loop or standard TURP. Perioperative parameters, treatment outcome, and adverse events associated with the surgical procedure are assessed herein. RESULTS: Mean operation time, changes in hemoglobin levels, resected prostate weight, perioperative irrigant volume needed, and incidences of recatheterizations and readmissions, all differed significantly when the two surgical procedures were compared. The average expense differences for the two procedures were impressive (p < 0.0001). No postoperative intergroup sexual dysfunction differences were noted. Clinical improvements following either TUVRP or TURP were significant and sustained for at least a period of 2 years. Intergroup comparison of International Prostate Symptom Score, quality of life, peak flow rate, and postvoid residual volume revealed no significant differences at 2 years (p = 0.45, 0.48, 0.12, and 0.29, respectively). The need for postoperative medical retreatment and/or reoperation did not differ significantly between the two groups (p = 0.62 and p = 0.56, respectively, at 6 months and p = 0.47 and p = 0.48, respectively, at 2 years). CONCLUSIONS: The TUVRP procedure offers advantages as regards a number of perioperative parameters when compared with the TURP procedure, and it seems that TUVRP might provide at least an equivalent treatment outcome as is the case for TURP.

Aged↗

PubMed1992

Hemodynamic changes after resection of thoracic duct for en bloc resection of esophageal cancer.

An en bloc resection of esophageal cancer is one of the most radical forms of esophagectomy, and includes the resection of the thoracic duct, but a relatively high hospital mortality rate has been reported. There is very little knowledge on the pathophysiological changes after resection of the thoracic duct. We examined 24 patients who underwent en bloc resection. Some patients developed severe tachycardia or shock postoperatively which subsided after a massive infusion of plasma. Analysis of the fluid balance revealed that much more fluid was necessary during surgery and the postoperative 24 h than in patients treated by a standard esophagectomy. Postoperative lymphangiography or CT revealed abnormal collateral lymphatics around the kidneys or in the pelvic cavity. This suggests the development of the lymphaticovenous shunts, which differed depending on the anatomy of each patient. One patient with chronic hepatitis developed uncontrollable ascites. These are important findings which can hopefully reduce the high rate of hospital death after this operation.

Aged↗

PubMed2001

Hybrid laparoscopic flexure takedown and open procedure for rectal resection is associated with significantly shorter length of stay than equivalent open resection.

PURPOSE: Laparoscopic-assisted, sphincter-saving resection (largest incision < 7 cm) of the middle and distal rectum is technically very difficult and, with regard to cancers, has not been demonstrated to be oncologically safe. The hypothesis of this retrospective study is that a hybrid operation that combines laparoscopic and open methods would be associated with short-term outcome benefits compared with open surgery results for patients undergoing sphincter-saving proctectomy. METHODS: A total of 31 hybrid and 25 fully open rectal resection patients were compared in this retrospective review. All patients had splenic flexure takedown and rectal anastomosis. The hybrid approach consisted of laparoscopic splenic flexure takedown (with or without partial rectal mobilization and devascularization) followed by completion of the procedure via infraumbilical midline laparotomy. The indication was neoplasm in 87 percent of hybrid patients and in 68 percent of open patients. The majority of tumors were located between 4 and 10 cm from the dentate line. RESULTS: Fifty-eight percent of hybrid and 68 percent of open patients had low anterior or coloanal resections, and 48 percent of hybrid and 64 percent of open patients underwent temporary diversion via ileostomy. The mean hybrid midline incision length was 11 cm compared with 24 cm for open patients (P < 0.0001). The neoplastic specimens were similar with regard to margins and lymph node harvest. Similar complication rates were noted in both groups. Nonsignificant benefits for hybrid patients (0.9-1.2 days) were seen with regard to length of time until toleration of liquid or solid diet and first flatus. Hybrid patients experienced their first bowel movements 4.1 days vs. 5.7 days for the open group (P = 0.03). Mean length of stay was significantly shorter for hybrid patients (6.1. days) than for open patients (11.1 days; P = 0.0006). CONCLUSION: This preliminary retrospective study suggests that a combined hybrid laparoscopic and open approach to sphincter-saving proctectomy permits a similar resection as open methods and may be associated with a length-of-stay benefit and more rapid return of bowel function. Prospective studies will be needed before any firm conclusions can be drawn.

Adult↗