LYMPH NODE HARVESTING IN LAPAROSCOPIC VERSUS OPEN COLECTOMY; A COMPARATIVE STUDY
Mohamed Korayem Fattouh Hamed;
Abstract
Laparoscopiccolorectalsurgeryisthemostsignificanttechnicaldevelopmentincolo-rectalsurgeryoverthelastdecade.
Severalissueswereraisedagainsttheuseoflaparoscopyincasesofmalignancy.Oneoftheseissueswastheadequacyoftheobtainedspecimensespeciallyinthosecasesthatarecandidateforradicalresection.
Takingthenumberoflymphnodesasanindicatorfortheradicalityofthesurgerydonewiththenumberof12lymphnodesbeingthetargetvalueasproposedbyrecentstudies,wefoundthatlaparoscopicresectionincasesofmalignancyyieldsadequatesamplesthatarecomparabletothoseobtainedbyopensurgery,ifnotbetterowingtothemagnifyingpowergivenbylaparoscopy.
However,adoptinglaparoscopicsurgicaltechniquesformalignantcasesisahighlydemandingtaskfromallthemembersoftheteami.e.thesurgeon,theassistants,thenurses,thetechnicianandthepathologist;eachmemberhasataskwithcertainrequirementsthatshouldbemetforthemaximumbenefittobeobtainedfromlaparoscopyforthesakeofthepatientandthecommunityonboththeshortandlongrun.
Detailedanatomyofthecolonandpelvisisamustforasafelaparoscopicprocedure.Also,understandingthephysiologicalresponseofthebodytopneumoperitoniumisessentialforasmoothintra-operativeandpost-operativemanagementofpatients.
Itwasalsoveryclearthatasuccessfulmanagementofapatientwithcolo-rectalcancer,andinthesamemanneranysurgicalpatient,isaresultofcollaborationbetweendifferentspecialtiesaddinganothercallfortheimportanceofestablishingmulti-disciplinaryteamswhereeverymemberco-operateswithotherstotakeadecisionputtingthepatientontherighttracktoreachtheutmostbenefitforthepatientincomparisontotheoldconceptofperson`sownexperienceandpreference.Indeed,surgeon`soldexperienceisveryimportant,but,alone,themissioncannotbecompletedsatisfactorily.
Severalissueswereraisedagainsttheuseoflaparoscopyincasesofmalignancy.Oneoftheseissueswastheadequacyoftheobtainedspecimensespeciallyinthosecasesthatarecandidateforradicalresection.
Takingthenumberoflymphnodesasanindicatorfortheradicalityofthesurgerydonewiththenumberof12lymphnodesbeingthetargetvalueasproposedbyrecentstudies,wefoundthatlaparoscopicresectionincasesofmalignancyyieldsadequatesamplesthatarecomparabletothoseobtainedbyopensurgery,ifnotbetterowingtothemagnifyingpowergivenbylaparoscopy.
However,adoptinglaparoscopicsurgicaltechniquesformalignantcasesisahighlydemandingtaskfromallthemembersoftheteami.e.thesurgeon,theassistants,thenurses,thetechnicianandthepathologist;eachmemberhasataskwithcertainrequirementsthatshouldbemetforthemaximumbenefittobeobtainedfromlaparoscopyforthesakeofthepatientandthecommunityonboththeshortandlongrun.
Detailedanatomyofthecolonandpelvisisamustforasafelaparoscopicprocedure.Also,understandingthephysiologicalresponseofthebodytopneumoperitoniumisessentialforasmoothintra-operativeandpost-operativemanagementofpatients.
Itwasalsoveryclearthatasuccessfulmanagementofapatientwithcolo-rectalcancer,andinthesamemanneranysurgicalpatient,isaresultofcollaborationbetweendifferentspecialtiesaddinganothercallfortheimportanceofestablishingmulti-disciplinaryteamswhereeverymemberco-operateswithotherstotakeadecisionputtingthepatientontherighttracktoreachtheutmostbenefitforthepatientincomparisontotheoldconceptofperson`sownexperienceandpreference.Indeed,surgeon`soldexperienceisveryimportant,but,alone,themissioncannotbecompletedsatisfactorily.
Other data
| Title | LYMPH NODE HARVESTING IN LAPAROSCOPIC VERSUS OPEN COLECTOMY; A COMPARATIVE STUDY | Other Titles | الغدد الليمفاوية المحصودة فى عمليات استئصال القولون جراحياً أو بالمنظار، دراسة مقارنة | Authors | Mohamed Korayem Fattouh Hamed | Issue Date | 2016 |
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