Fleshman J W, Fry R D, Birnbaum E H, Kodner I J
Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Dis Colon Rectum. 1996 Jan;39(1):15-22. doi: 10.1007/BF02048262.
The purpose of this study was to compare laparoscopy with minilaparotomy approaches to colorectal diseases.
Outcomes after minilaparotomy and laparoscopy were prospectively compared for a 12-month period.
Minilaparotomy was performed in 35 patients to achieve right colectomy (14), left colectomy (8), total colectomy (2), low anterior resection (6), abdomino-perineal resection (2), colostomy (1), and ileal resection (1). Laparoscopic techniques were used in 52 patients to perform right colectomy (20), left colectomy (11), low anterior resection (5), abdominoperineal resection (7), total colectomy (3), ileal resection (1), colostomy (3), transverse colectomy (1), and colostomy closure (1). Mean operative times were 69 minutes for minilaparotomy (range, 33-180) and 173 minutes for laparoscopy (range, 60-300). Mean incision lengths were 12 (range 8-18) cm and 8 (range, 0-25) cm; mean time to bowel movement was four (range, 1-7) days and 3.9 (range, 0-8) days; mean day of discharge was 6.9 (range 3-15) days, and 6 (range, 1-15) days postoperatively, respectively. Laparoscopy procedures were completed in 39 of 52 patients (75 percent); mean time to bowel movement was 3.5 (range, 0-6) days, and mean day of discharge was 5.3 (range, 1-14) days (P = <0.005).
The use of a small incision, whether by minilaparotomy or by laparoscopy, results in similar early return of function and discharge.
