Laparoscopic-assisted versus open total mesorectal excision with anal sphincter preservation for mid and low rectal cancer: a prospective, randomized trial.

Background: This single-center, prospective, randomized trial was designed to compare the short-term clinical outcome between laparoscopic-assisted versus open total mesorectal excision (TME) with anal sphincter preservation (ASP) in patients with mid and low rectal cancer. Long-term morbidity and survival data also were recorded and compared between the two groups.

Methods: Between August 2001 and August 2007, 80 patients with mid and low rectal cancer were randomized to receive either laparoscopic-assisted (40 patients) or open (40 patients) TME with ASP.

Long-term oncologic outcomes of laparoscopic versus open surgery for rectal cancer: a pooled analysis of 3 randomized controlled trials.

Objective: To compare long-term oncologic outcomes between laparoscopic and open surgery for rectal cancer and to identify independent predictors of survival.

Background: Few randomized trials comparing laparoscopic and open surgery for rectal cancer have reported long-term survival data.

Methods: Data from the 3 randomized controlled trials comparing curative laparoscopic (n=136) and open surgery (n=142) for upper, mid, and low rectal cancer conducted at the Prince of Wales Hospital, Hong Kong, between September 1993 and August 2007 were pooled together for this analysis.

Laparoscopic colorectal fellowship training programme : a 6-year experience in a university colorectal unit.

Background: The aim of this study was to evaluate a structured training programme for laparoscopic colorectal surgery in a university colorectal unit over a 6-year period.

Methods: Data on patients who underwent laparoscopic colectomy between November 2004 and October 2010 were analyzed. Operations were performed either by the consultant colorectal surgeons or colorectal fellows.

Institution learning curve of laparoscopic colectomy--a multi-dimensional analysis.

Background: This study aimed to evaluate the learning curve for laparoscopic colorectal resection of a university colorectal unit, the operative outcome in its developing and established period of laparoscopic colorectal resection is compared.

Methods: We analyzed 1,031 consecutive patients who underwent laparoscopic colorectal resections for colorectal carcinoma performed in a colorectal unit between April 1992 and December 2008. Multi-dimensional analyses of the learning curves of the institution and seven individual surgeons were performed.

Laparoscopic-assisted versus open resection of right-sided colonic cancer--a prospective randomized controlled trial.

Purposes: This study aims to compare the perioperative outcomes and survival between laparoscopic-assisted right hemicolectomy (LARH) and open right hemicolectomy (ORH) for right-sided colon cancer.

Methods: Between July 1996 and October 2005, 145 patients were randomized to receive LARH (n = 71) or ORH (n = 74).

Results: The median follow-up of living patients was 99.

Emergency laparoscopic-assisted right hemicolectomy: can we achieve outcomes similar to elective operation?

The aim of this study was to compare short-term clinical outcomes of elective and emergency laparoscopic-assisted right hemicolectomy. Between January 2005 and December 2009, 181 patients had laparoscopic-assisted right hemicolectomy performed at our institute (148 elective and 33 emergency cases). The demographic data, operative details, and short-term outcomes were collected.

En bloc urinary bladder resection for locally advanced colorectal cancer: a 17-year experience.

Background And Objectives: En bloc bladder resection is often required for treating colorectal cancer with suspected urinary bladder invasion. Our aim was to review our institutional experience in en bloc resection of locally advanced colorectal cancer involving the urinary bladder over a period of 17 years.

Methods: The hospital records of 72 patients with locally advanced colorectal cancer who underwent en bloc urinary bladder resection at our institution between July 1987 and December 2004 were retrospectively reviewed.

Conversion in laparoscopic-assisted colectomy for right colon cancer: risk factors and clinical outcomes.

Purpose: Laparoscopic colon resection is technically challenging, and conversion to open surgery is sometimes unavoidable. The impact of conversion may vary among different types of colorectal resection and pathology. Our present study aims at evaluating the risk factors and clinical outcomes of conversion in laparoscopic resection for right colon cancer.

The learning curve for endorectal ultrasonography in rectal cancer staging.

Background: Endorectal ultrasound (ERUS) is an emerging technique for preoperative rectal cancer staging. It is an operator-dependent examination with accuracy closely related to endosonographer experience. In this study, we prospectively analyzed our results of ERUS staging for rectal cancer, aiming to determine its accuracy and to define the learning curve of the procedure.

Wavelet-denoising of electroencephalogram and the absolute slope method: a new tool to improve electroencephalographic localization and lateralization.

Objective: In ictal scalp electroencephalogram (EEG) the presence of artefacts and the wide ranging patterns of discharges are hurdles to good diagnostic accuracy. Quantitative EEG aids the lateralization and/or localization process of epileptiform activity.

Methods: Twelve patients achieving Engel Class I/IIa outcome following temporal lobe surgery (1 year) were selected with approximately 1-3 ictal EEGs analyzed/patient.

The learning curve for laparoscopic colectomy: experience of a surgical fellow in an university colorectal unit.

Background: This study aimed to evaluate the learning curve for laparoscopic colectomy of a surgical fellow in an university colorectal unit using a structured training protocol.

Methods: This study analyzed the data from 100 consecutive patients who had laparoscopic colectomy performed by a surgical fellow between 11/2004 and 12/2007. The structured training protocol required the fellow to assist more than 40 laparoscopic colectomies before embarking on his first case.

Emergency laparoscopic-assisted versus open right hemicolectomy for complicated cecal diverticulitis: a comparative study.

Background: Emergency open colectomy is generally agreed, by most surgeons, to be the treatment of choice for complicated cecal diverticulitis. However, the literature on the use of laparoscopy in treating this surgical emergency is scanty. This study aimed to evaluate the feasibility and safety of emergency laparoscopic-assisted right hemicolectomy for complicated cecal diverticulitis and to compare its operative and short-term clinical outcomes with the open approach.

Long-term morbidity and oncologic outcomes of laparoscopic-assisted anterior resection for upper rectal cancer: ten-year results of a prospective, randomized trial.

Purpose: We have previously reported the five-year results of a randomized trial comparing laparoscopic and open resection for cancer of the upper rectum and rectosigmoid junction. The aim of this follow-up study is to report on the long-term morbidity and ten-year oncologic outcomes among the subgroup of patients with upper rectal cancer.

Methods: From September 1993 to October 2002, 153 patients with upper rectal cancer were randomly assigned to receive either laparoscopic-assisted (n = 76) or open (n = 77) anterior resection.

Laparoscopic-assisted versus open abdominoperineal resection for low rectal cancer: a prospective randomized trial.

Background: Laparoscopic resection of colonic cancer has been shown to improve postoperative recovery without jeopardizing tumor clearance and survival, but information on low rectal cancer is scarce. The aim of this randomized trial was to compare postoperative recovery between laparoscopic-assisted versus open abdominoperineal resection (APR) in patients with low rectal cancer. Recurrence and survival data were also recorded and compared between the two groups.

Emergency laparoscopic-assisted versus open right hemicolectomy for obstructing right-sided colonic carcinoma: a comparative study of short-term clinical outcomes.

Background: The aim of the present study was to compare the clinical outcomes of emergency laparoscopic-assisted versus open right hemicolectomy for obstructing right-sided colonic carcinoma.

Methods: Between July 2003 and July 2006, 43 consecutive patients with obstructing right-sided colonic carcinoma underwent emergency right hemicolectomy at our institution, 14 with the laparoscopic-assisted approach and 29 with the open approach. Clinical data were retrospectively recorded and compared between the two groups.

Synchronous laparoscopic resection of colorectal and renal/adrenal neoplasms.

Synchronous laparoscopic resections of coexisting abdominal diseases are shown to be feasible without additional postoperative morbidity. We report our experience with synchronous laparoscopic resection of colorectal carcinoma and renal/adrenal neoplasms with an emphasis on surgical and oncologic outcomes. Five patients diagnosed to have synchronous colorectal carcinoma and renal/adrenal neoplasms (renal cell carcinoma in 2 patients, adrenal cortical adenoma in 2 patients, and adrenal metastasis in 1 patient) underwent synchronous laparoscopic resection.

Outcome of radical excision of anorectal gastrointestinal stromal tumors in Hong Kong Chinese patients.

Anorectal gastrointestinal stromal tumor (GIST) is a rare disease entity with malignant potential. Medical records of six patients (median age 68 years) with anorectal GIST who underwent surgical treatment at our institution between 1992 and 1999 were retrospectively reviewed. Four patients presented with rectal bleeding.

Air-inflated magnetic resonance colonography in patients with incomplete conventional colonoscopy: Comparison with intraoperative findings, pathology specimens, and follow-up conventional colonoscopy.

Background: To assess the usefulness of air-inflated magnetic resonance colonography (MRC) in patients with incomplete conventional colonoscopy (CC).

Methods: From September 2001 to December 2004, 51 patients (25 male and 26 female, age range 32 to 85 years) with incomplete colonoscopy were recruited to have MRC performed. Half-fourier single short turbo spin echo (HASTE) axial, coronal, and three dimensional fat suppressed gradient echo sequence (VIBE) coronal images in both the prone and supine positions were performed for each patient.

Portal venous gas and thrombosis in a Chinese patient with fulminant Crohn's colitis: a case report with literature review.

Ever since its earliest reports, portal venous gas (PVG) has been associated with numerous intraabdominal catastrophes and has served as an indication for urgent surgical exploration. It is traditionally regarded to be an ominous finding of impending death, with highest mortality reported in patients with underlying bowel ischemia. Today, computed tomography has demonstrated a wider range of clinical conditions associated with PVG, some of which are "benign" and do not necessarily require surgery, unless when there are signs of intraabdominal catastrophe or systemic toxicity.

Simultaneous laparoscopic resection of rectal cancer and liver metastasis.

Simultaneous resection of colorectal tumor and liver metastasis has been advocated because of the benefits of avoiding a second operation, reduced morbidity, shorter treatment time, and similar outcomes. We report a case of simultaneous laparoscopic resection. The operative time was 350 minutes and the estimated blood loss was 500 mL.

Emergency laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma.

Background: We report our preliminary experience in urgent laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma.

Materials And Methods: From January to April 2005, seven consecutive patients with obstructing right-sided colon carcinoma underwent emergency laparoscopically assisted right or extended right hemicolectomy. Patient demographic data, operative details, and short-term clinical outcomes were prospectively collected and analyzed.

Laparoscopic spleen-preserving pancreatectomy for traumatic pancreatic transection: a case report.

Pancreatic transection from blunt trauma is uncommon. A 33-year-old woman suffered from blunt pancreatic trauma after a traffic accident. Computed tomography of the abdomen showed full thickness laceration through the body of the pancreas.

Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial.

Background: Although laparoscopic resection of colorectal carcinoma improves post-operative recovery, long-term survival and disease control are the determining factors for its application. We aimed to test the null hypothesis that there was no difference in survival after laparoscopic and open resection for rectosigmoid cancer.

Methods: From Sept 21, 1993, to Oct 21, 2002, 403 patients with rectosigmoid carcinoma were randomised to receive either laparoscopic assisted (n=203) or conventional open (n=200) resection of the tumour.

A new abdominal drain insertion technique after a cirrhotic liver resection to prevent ascitic leakage.

A simple technique for inserting an abdominal drain is reported to prevent the leakage of ascitic fluid at the abdominal drainage site after a cirrhotic liver resection. This technique consists of inserting the abdominal drain through a subcutaneous tract. When the drain is then removed during the postoperative period, the pressure of the ascitic fluid that has built up in the peritoneal cavity causes pressure which thus obliterates the subcutaneous tract and thereby prevents leakage.