New technique of laparoscopic colectomy with the LAP DISC and a 5-mm flexible scope

Retrospective, matched case-control study comparing the oncologic outcomes between laparoscopic surgery and open surgery in patients with right-sided colon cancer

PURPOSE

The short- and long-term outcomes of laparoscopic surgery for right-sided colon cancer remain largely uninvestigated. This study was undertaken to compare the morbidity and mortality after either a laparoscopic right hemicolectomy (LRHC) or an open right hemicolectomy (ORHC) for this type of tumor.

METHODS

The study group included 100 patients who underwent an LRHC and 100 patients who underwent an ORHC for right-sided colon cancer from 1990 through 2004. The two groups were retrospectively well matched with respect to sex, age (+/-5 years), and pathological tumor-node-metastasis (TNM) stage.

RESULTS

The median follow-up period was 83 months in the LRHC group and 105 months in the ORHC group. The LRHC group had a lower volume of intraoperative bleeding (P < 0.001), a lower rate of wound infection (P = 0.019) or postoperative intestinal obstruction (P = 0.013), and a shorter hospital stay (P < 0.001) than the ORHC group. The rate of recurrence did not differ significantly between the LRHC group (19%) and the ORHC group (22%). In patients with TNM stage I or II, the disease-free survival (DFS) rate (94.9% vs 95.1%) and overall survival (OS) rate (95.8% vs 95.0%) did not differ significantly between the two groups. A similar tendency was observed in patients with stage III with the rates for DFS (71.3% vs 60.4%) and OS (73.6% vs 64.1%), respectively.

CONCLUSIONS

An LRHC for right-sided colon cancer has the advantage over an ORHC of better short-term outcomes, and both groups have similar long-term oncologic outcomes. An LRHC is thus an acceptable alternative to an ORHC for the treatment of this type cancer.

Cleaning the laparoscopic camera port by a microbiology culture swab

INTRODUCTION

The 5-mm camera is currently widely utilized in Laparoscopic surgery. A disturbing problem for the laparoscopic surgeon is when this Port is becoming smudged by fat or blood, affecting the cleanliness of the 5-mm camera lens after insertion. Due to its narrow, long tube, cleaning this port is tricky. In this paper, we advocate a simple, cheap, and effective method for preventing the staining of the port, using a sterile culture swab stick.

METHODS

Once the first port is inserted, it will be cleaned with a sterile culture swab with a repeated in-and-out movement inside the port to clean it circumferentially until there is no further smudging of the swab. The camera is then introduced into the abdominal cavity. Each time either fat or blood stain the port, the culture swab stick is then utilized to wipe it.

RESULTS

In our experience, the use of the culture swab stick beforehand to clean the 5-mm camera port prior to insertion renders the use of any other cleaning method unnecessary.

CONCLUSION

Using the microbiology sterile culture swab stick to clean the 5-mm camera port is a simple, cheap method to clean the port from any debris.