Erschienen in:
01.12.2003 | Letters to the Editor
Reply (DOI: 10.1007/s00268-003-1029-z)
verfasst von:
Jin-Tung Liang, M.D.
Erschienen in:
World Journal of Surgery
|
Ausgabe 12/2003
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Excerpt
We appreciate the comment from Dr. Bacal and colleagues on our article [
1] regarding the medial-to-lateral laparoscopic dissection sequence for the resection of rectosigmoid cancers. As we mentioned in this article, Dr. Leroy is one of the original advocates of this kind of laparoscopic approach. Besides the technical advantages detailed in the Discussion of our article, we agree that the medial-to-lateral approach is well adapted to laparoscopy, because of the medial-to-lateral view offered by the scope. However, as we traced the evolution of the surgical technique of laparoscopic colectomy, it was obvious that most pioneering laparoscopic surgeons initially tried to dissect the colorectum according to experience gained from open surgery—i.e., the lateral-to-medial dissection sequence. Even to date, some experienced laparoscopic surgeons still insist on the use of the lateral-to-medial dissection sequence. Advocates of the lateral-to-medial dissection sequence postulated that it was the patient’s posture, and the surgeon’s position and personal skill, but not the medial-to-lateral or lateral-to-medial approach that determined the surgical efficiency. Moreover, because all laparoscopic surgeons seek to demonstrate that laparoscopic colectomy for treatment of colorectal cancer is similar to traditional open surgery in terms of treatment outcome, the data will be more convincing, if the patients randomized to open and laparoscopic groups are matched in terms of baseline data, including the dissection sequence. …