World journal of surgery
-
World journal of surgery · Mar 1996
Comparative StudyLaparoscopic colorectal surgery: ascending the learning curve.
The aim of this study was to prospectively assess the results of our first 100 consecutive patients who underwent laparoscopic or laparoscopy-assisted colorectal operations. The parameters studied included the type and length of procedure, intra- and postoperative complications, conversion to open surgery, length of ileus, and hospitalization. A total of 100 laparoscopic and laparoscopy-assisted procedures were performed between May 1991 and April 1994. ⋯ We conclude that the feasibility of laparoscopic colorectal surgery has been well established. The morbidity associated with laparoscopic colorectal surgery correlates with a steep learning curve but is also related to the type of procedure. TAC is associated with a higher complication rate than are other laparoscopic colorectal procedures.
-
Surgical treatment for adrenal disease may be withheld from elderly patients because of concern about prohibitive operative morbidity and mortality. To obtain objective data in our practice, we analyzed the results of adrenalectomy for patients aged 65 years and older. From 1984 to 1993 there were 85 patients (41 men, 44 women) with ages ranging from 65 to 84 years (median 69 years) who underwent adrenalectomy for Cushing syndrome (n = 19), pheochromocytoma (n = 16), adrenocortical carcinoma (n = 7), benign adenoma (n = 26), or primary hyperaldosteronism (n = 17) at our institution. ⋯ Goldman class II or greater was an excellent predictor of increased morbidity (p = 0.032) and mortality (p = 0.036). With the exception of adrenocortical carcinoma, adrenal surgery for elderly patients can be performed with acceptable morbidity and mortality. The Goldman multifactorial cardiac risk scheme reliably predicts postoperative outcome in this elderly group of patients.