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  • Laparoscopic sigmoid resection in an older patient with impaired renal function = Laparoskopska resekcija sigme pri starostniku z okvarjenim delovanjem ledvic
    Korolija, Dragan ...
    Background. The use of laparoscopic colorectal surgery has increased much in recent years. Its advantages, i.e. lesser surgical stress and reduced impact on the immune system, which have been ... recently reported in the literature, have encouraged surgeons to use the laparoscopic approach in older patients with serious co-morbidity. Patient and methods. A 78-year-old patient with sigmoid carcinorna was operated on via the laparoscopic approach. The patient had impaired renal function with average preoperative creatinine levels of 300to 350 microm/I, and presented with symptoms of senile dementia and reducedrespiratory function. Results. The tumor was located 20 cm from the anal verge. Central vascular ligation and disection of the mesocolon from the medial to the lateral side were performed according to the standard principlesof laparoscopic sigmoid resection. The patient was intensively monitored intraoperatively and on the first postoperative day. Liquids were given on the first postoperative day. The creatinine levels increased to 400 micromol/L and returned to preoperative values five days after surgery. The patient required no renal support (dialysis) and was discharged from the hospital one week after surgery with a confirmed diagnosis of Stage III adenocarcinoma. Conclusion. The minimally invasive approach has proved appropriate for older patients with colonic cancer. The results of laparoscopic sigmoid resection performed in our patient confirmed the literature data on lesser surgical stress associated with minimally invasive techniques. In conclusion, laparoscopic surgery is applicable to older patients with serious co-morbidity.
    Vir: Endoskopska revija : glasilo Sekcije za endoskopsko kirurgijo in Sekcije za gastroenterološko endoskopijo Slovenije = Endoscopic review : journal of Slovenian Society of Endoscopic Surgery and Society of Gastroenterologic Endoscopy. - ISSN 1318-8941 (Letn. 9, št. 22, nov. 2004, str. 31-35)
    Vrsta gradiva - članek, sestavni del
    Leto - 2004
    Jezik - angleški
    COBISS.SI-ID - 19043033

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