Diseases of the colon and rectum
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This study was designed to compare outcomes after elective laparoscopic and conventional colorectal surgery over a ten-year period using data from the English National Health Service Hospital Episode Statistics database. ⋯ In the present study, patients selected for laparoscopic colorectal surgery were associated with reduced postoperative mortality when compared with those undergoing the conventional technique. This finding merits further investigation.
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The purpose was to determine if the perioperative benefits associated with laparoscopic colectomies are maintained as operative time increases. ⋯ Increasing operative time does not appear to adversely affect perioperative outcomes in segmental colectomies. Total abdominal colectomies lasting more than 270 minutes were associated with increased postoperative complications, days to surgical diet, and length of stay.
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Circumferential resection margin involvement after rectal cancer surgery is associated with local recurrence and decreased survival, but definitions of "safe" margins vary. This study assessed the influence of various circumferential margins on long-term outcome from rectal cancer surgery. ⋯ Circumferential margins < or =2 mm are associated with significantly reduced cancer-specific survival, and margins < or =1 mm with increased local recurrence, when other factors are accounted for, challenging the assumption that a circumferential resection margin of < or =1 mm is safe.