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  1. Article ; Online: Is laparoscopic colectomy as cost beneficial as open colectomy?

    Shabbir, Asim / Roslani, April C / Wong, Kutt-Sing / Tsang, Charles B S / Wong, Hwee-Bee / Cheong, Wai-Kit

    ANZ journal of surgery

    2009  Volume 79, Issue 4, Page(s) 265–270

    Abstract: Background: Laparoscopic colectomy has yet to gain widespread acceptance in cost-conscious health-care institutions. The aim of the present study was to define the cost-benefit relationship of laparoscopic versus open colectomy.: Methods: Thirty-two ... ...

    Abstract Background: Laparoscopic colectomy has yet to gain widespread acceptance in cost-conscious health-care institutions. The aim of the present study was to define the cost-benefit relationship of laparoscopic versus open colectomy.
    Methods: Thirty-two consecutive patients undergoing elective laparoscopic colectomy (LC) by a single colorectal surgeon between August 2004 and September 2005 were reviewed. Cases were matched with a historical cohort undergoing elective open colectomy (OC) between June 2003 and July 2004. Demography, perioperative data, histopathology and cost were compared.
    Results: Both groups had similar demographics. Most resections (90.6%) were for cancer. Operative time was significantly longer for LC compared to OC (180 min vs 110 min, P < 0.001). Four patients (12.5%) in the LC group required conversion. LC patients, however, had lower median pain scores (3, 2 and 1 vs 6, 4 and 2 at 24, 48 and 72 h postoperatively, P < 0.001), faster resolution of ileus (3 vs 4 days, P < 0.001) and earlier discharge (6 vs 9 days, P < 0.001) compared to the OC group. As a result, overall hospital cost for both procedures was not significantly different (US$7943 vs US$7253, P = 0.41).
    Conclusion: Laparoscopic colectomy is as cost-beneficial in the short term as open colectomy.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Colectomy/economics ; Colonic Neoplasms/surgery ; Cost-Benefit Analysis ; Diverticulosis, Colonic/surgery ; Female ; Humans ; Laparoscopy/economics ; Male ; Middle Aged
    Language English
    Publishing date 2009-04
    Publishing country Australia
    Document type Comparative Study ; Journal Article
    ZDB-ID 2050749-5
    ISSN 1445-2197 ; 1445-1433 ; 0004-8682
    ISSN (online) 1445-2197
    ISSN 1445-1433 ; 0004-8682
    DOI 10.1111/j.1445-2197.2009.04857.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  2. Article: Management of acute bleeding per rectum.

    Tan, Benita K T / Tsang, Charles B S / Nyam, Denis C N K / Ho, Yik Hong

    Asian journal of surgery

    2004  Volume 27, Issue 1, Page(s) 32–38

    Abstract: Background: Bleeding per rectum is a common indication for acute hospital admissions to the colorectal department. The frequencies of aetiologies in Singapore are different from those in Western populations. A retrospective analysis of the demography, ... ...

    Abstract Background: Bleeding per rectum is a common indication for acute hospital admissions to the colorectal department. The frequencies of aetiologies in Singapore are different from those in Western populations. A retrospective analysis of the demography, pathology and management of acute bleeding per rectum was performed to determine the outcome and difference in aetiology from the West.
    Methods: During the 1-year period from 1 October 1995 to 30 September 1996, 547 patients were admitted to Singapore General Hospital form the emergency department for acute bleeding per rectum. There were 377 males and 170 females; the mean age was 42 years (range, 15-97 years).
    Results: Of the patients admitted, 87% wer admitted due to perianal conditions diagnosed at bedside proctoscopy, where haemorrhoids mad up 94%. One percent bled from the upper gastrointestinal tract, while 12% bled from colorectal pathology. Massive bleeding form the colorectum was uncommon. Less than one third of the 47 patients required blood transfusions. Colonoscopy was the most useful diagnostic tool for bleeding from the colorectum. The more common colonic pathologies were diverticular disease (33%), adenomas (18%), and malignancy (26%), accounting for the majority of acute patient admissions. Colonic causes of bleeding were less common and were most stable. There were differences in the frequencies of aetiologies in our population compared ot Western populations. Understanding the common pathologies and outcomes guides the management fo our patients.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Algorithms ; Female ; Gastrointestinal Hemorrhage/epidemiology ; Gastrointestinal Hemorrhage/etiology ; Gastrointestinal Hemorrhage/therapy ; Humans ; Incidence ; Male ; Middle Aged ; Rectal Diseases/epidemiology ; Rectal Diseases/etiology ; Rectal Diseases/therapy ; Retrospective Studies ; Singapore/epidemiology
    Language English
    Publishing date 2004-01
    Publishing country China
    Document type Journal Article
    ZDB-ID 1068461-x
    ISSN 1015-9584
    ISSN 1015-9584
    DOI 10.1016/S1015-9584(09)60241-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 2831: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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