Laparoscopic Anterior Resections Use Fewer Defunctioning Stomas.

It is our contention that with the improved visualization of the operating field afforded by laparoscopic surgery, that during laparoscopic anterior resection fewer drains and defunctioning stomas are being utilized. We assessed a single consultant surgeon’s anterior resectional practice.

A retrospective study compared all laparoscopic anterior resections (LAR) versus open anterior resections (OAR) conducted by a single consultant surgeon over a five year period from January 2003 to June 2008, who changed his practice from open to laparoscopic surgery in January 2005. We compared the total theatre time, the use of drains and the number of defunctioning stomas constructed. Additionally, rates of neoadjuvant therapy and anastomotic leak were assessed, along with the height of tumour above the anal verge. Data was extracted from theatre records and operation/patient notes from 38 consecutive patients who underwent anterior resection.

Data were compared from 22 laparoscopic vs. 16 open anterior resections (there was one laparoscopic to open conversion). There was no significant difference in mean total theatre time (to include anaesthetic/epidural and laparoscopic equipment setup times) of OAR compared to LAR (OAR=227 minutes vs. LAR = 245 minutes, t=0.741, p=0.464). No drains were inserted during any of the LAR compared to seven in OAR (p

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Program Number: P162

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