Hand-assisted laparoscopic surgery had both technical advantages of open surgery and better postoperative short-term follow-up results of laparoscopic surgery. We compared open colectomy, laparoscopic colectomy and hand-assisted laparoscopic colectomy, and tried to find the most effective operative modality.

90 patients, who were diagnosed with colorectal cancer and underwent colectomy in our institution, were categorized as 3 groups of open colectomy (OC) group, laparoscopic colectomy (LC) group and hand-assisted laparoscopic colectomy (HALC) group by the surgical modality.

In this study, ratio of male and female was 57 : 37, and mean age was 64.1 years old. LC group and HALC group showed longer operation time, shorter hospital stay after operation, lesser pain and earlier removal of closed drainage catheter than OC group. Amount of bleeding during operation, frequency of transfusion and incidence of complication showed no significant difference. In permanent pathologic results, the number of harvested lymph nodes had significant difference between OC group and other groups (P=0.030), but it was probably caused by the bias of the different distribution of the stages in each group. Overall 14 of the cases resulted in complications while there was no mortality.

Laparoscopic colectomy and hand-assisted laparoscopic colectomy showed better short-term follow-up results rather than open colectomy. And hand-assisted laparoscopic surgery could provide tactile sensation to operator, which lacked in laparoscopic surgery. Hand-assisted laparoscopic colectomy could be an alternative surgical option for colorectal cancer with these advantages.

The purpose of study is to compare the laparoscopic appendectomy with the open appendectomy in the clinical outcomes.

From March 2001 to June 204, a total 118 appendectomy were retrospectively reviewed. These were comprised of 57 laparoscopic appendectomy (LA), and 61 open appendectomy (OA) selected by random method among 1193 poen appendectomy cases during same period. Hospital stay, length of operation times, recovery of bowel function, postoperative complication, postoperative pain, pathologic classification were compared in both groups.

The operation times were 68.6 minutes (LA) and 51.6 minutes (OA), respectively (p=0.021). There no statistical differences in the duration of hospital stay, recovery of bowel function, complication rate, although LA group trend the shorter duration of the hospital stay, faster recovery of bowel function and low rarte of complication than OA group. The patient's satisfaction was higher in LA group than OA because of the operation wound scar.

The LA was no difference clinical outcomes except operation time as compared with OA. LA, however, may be have the merit of minimal invasive surgery and satisfaction of patient. So, LA method is attractive option for the management of appendicitis.