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The short-term outcomes of laparoscopic multivisceral resection for locally advanced colorectal cancer: our experience of 39 cases

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Abstract

Purpose

Laparoscopic surgery for locally advanced colorectal cancer suspected of direct invasion to adjacent organs or structures remains controversial because of its high conversion rate, inadequate oncologic clearance and surgical outcomes. This study retrospectively evaluated the short-term outcomes of laparoscopic multivisceral resection for colorectal cancer and investigated the factors influencing conversion to open surgery.

Methods

Between 2010 and 2015, 39 patients who underwent laparoscopic multivisceral resection for colorectal cancer intraoperatively suspected of direct invasion to adjacent organs or structures were included. The conversion rate, resection margin status, surgical results, and morbidity and mortality rates were evaluated. We also investigated the factors influencing conversion.

Results

The conversion rate was 28 %. The resection margin was negative in all cases. The median operative time was 247 min, and the median blood loss was 80 ml. The postoperative mortality rate was 0 %, and the morbidity rate was 28 %; complications of Grade 3 or more were observed in 2 patients (5 %). The factors influencing conversion were ≥2 adherent organs (p = 0.028) and clinical suspicion of direct invasion to adjacent organs (cT4b) (p = 0.076).

Conclusion

Laparoscopic multivisceral resection for colorectal cancer intraoperatively suspected of direct invasion to adjacent organs or structures is feasible in selected patients. Conversion is more likely with ≥2 adherent organs and cT4b.

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Authors and Affiliations

  1. Department of Surgery, Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan

    Yuichiro Miyake, Junichi Nishimura, Hidekazu Takahashi, Naotsugu Haraguchi, Taishi Hata, Tsunekazu Mizushima, Hirofumi Yamamoto, Yuichiro Doki & Masaki Mori

  2. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, S-1, W-17, Chuo-ku, Sapporo, Hokkaido, 060-8556, Japan

    Ichiro Takemasa

Authors
  1. Yuichiro Miyake
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  2. Junichi Nishimura
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  3. Hidekazu Takahashi
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  4. Naotsugu Haraguchi
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  9. Yuichiro Doki
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Correspondence to Junichi Nishimura.

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Miyake, Y., Nishimura, J., Takahashi, H. et al. The short-term outcomes of laparoscopic multivisceral resection for locally advanced colorectal cancer: our experience of 39 cases. Surg Today 47, 575–580 (2017). https://doi.org/10.1007/s00595-016-1429-y

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  • DOI: https://doi.org/10.1007/s00595-016-1429-y

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