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Influence of previous abdominal surgery on surgical outcomes between laparoscopic and open surgery in elderly patients with colorectal cancer: subanalysis of a large multicenter study in Japan

  • Original Article—Alimentary Tract
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Abstract

Background

The aim of the present study was to examine the technical and oncological feasibility of laparoscopic surgery (LAP) in elderly patients with a history of abdominal surgery.

Methods

We conducted a propensity score-matched case–control study of colorectal cancer (CRC) patients aged ≥80 years that were treated at 41 hospitals between 2003 and 2007. We included 601 patients who had a history of abdominal surgery and underwent curative and elective surgery for stage 0 to III CRC. After the matching procedure, 153 patients were included in each cohort. The surgical outcomes of LAP and open surgery (OS) were compared. P-values of <0.05 were considered statistically significant.

Results

LAP resulted in a significantly longer surgical time (220 vs. 170 min, p < 0.001), but significantly less intraoperative blood loss (39 vs. 100 ml, p < 0.001). A number of postoperative recovery-related parameters, including the length of the hospitalization period (12 vs. 14 days, p = 0.002), and the days to the resumption of fluid (2 vs. 3 days, p < 0.001) and solid food intake (4 vs. 5 days, p < 0.001), were significantly better in the LAP group. Moreover, the overall morbidity rate (43 vs. 66 %, p = 0.009) and the frequency of postoperative ileus (7 vs. 19 %, p = 0.023) were significantly lower in the LAP group, while the frequencies of other morbidities did not differ significantly between the groups. In the survival analyses, overall survival and disease-free survival did not differ between the two groups.

Conclusions

In this population, LAP can be performed safely in elderly CRC patients with a history of abdominal surgery, and LAP resulted in a lower postoperative morbidity rate than OS.

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Acknowledgments

We appreciate the great advice provided by Minoru Hattori, Advanced Medical Skills Training Center, Hiroshima University, regarding the statistical analyses, and we owe our deepest gratitude to the following members of the Japan Society of Laparoscopic Colorectal Surgery for their cooperation: Kunihisa Shiozawa, Ageo Central General Hospital; Hiroyuki Bando, Daisuke Yamamoto, Ishikawa Prefectural Central Hospital; Seigo Kitano, Masafumi Inomata, Tomonori Akagi, Oita University; Junji Okuda, Keitaro Tanaka, Osaka Medical College; Masayoshi Yasui, Osaka National Hospital; Kosei Hirakawa, Kiyoshi Maeda, Osaka City University; Junichi Hasegawa, Junichi Nishimura, Osaka Rosai Hospital; Hiroya Kuroyanagi, Cancer Institute Hospital of JFCR; Hisanaga Horie, Jichi Medical University; Masaki Naito, Kitasato University; Takashi Ueki, Kyushu University; Yoshiharu Sakai, Koya Hida, Yousuke Kinjo, Kyoto University; Yukihito Kokuba, Kyoto Prefectural University; Madoka Hamada, Kochi Health Sciences Center; Norio Saito, Masaaki Ito, National Cancer Hospital East; Toshimasa Yatsuoka, Saitama Cancer Center; Jo Tashiro, Shigeki Yamaguchi, Saitama Medical University International Medical Center; Tomohisa Furuhata, Kenji Okita, Sapporo Medical University; Yoshiro Kubo, Shikoku Cancer Center; Shuji Saito, Yusuke Kinugasa, Shizuoka Cancer Center; Fumio Konishi, Saitama Medical Center Jichi Medical University; Kazuhiro Sakamoto, Michitoshi Goto, Juntendo University; Junichi Tanaka, Shungo Endo, Showa University Northern Yokohama Hospital; Nobuyoshi Miyajima, Tadashi Suda, St. Marianna University; Yoshihisa Saida, Toshiyuki Enomoto, Toho University Ohashi Medical Center; Yasuhiro Munakata, Ken Hayashi, Souichi Tagami, Nagano Municipal Hospital; Yasumasa Takii, Satoshi Maruyama, Niigata Cancer Center Hospital; Takao Ichihara, Nishinomiya Municipal Central Hospital; Hitoshi Idani, Kohei Kurose, Fukuyama Municipal Hospital; Yasuhiro Miyake, Minoh City Hospital; Shoichi Hazama, Yamaguchi University; Shoichi Fujii, Shigeru Yamagishi, Kazuteru Watanabe, Yokohama City University Medical Center; Kenichi Sugihara, Tokyo Medical and Dental University Graduate School, Shin Fujita, National Cancer Center Hospital. This study was supported by the Japanese Society for Cancer of the Colon and Rectum.

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Authors and Affiliations

  1. Division of Gastrointestinal Surgery, Hiratsuka City Hospital, 19-1-1, Minamihara, Hiratsuka, Kanagawa, 254-0065, Japan

    Seiichiro Yamamoto

  2. Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Takao Hinoi & Hiroaki Niitsu

  3. Department of Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan

    Takao Hinoi

  4. Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan

    Masazumi Okajima

  5. Department of Surgery, Suita Municipal Hospital, Suita, Japan

    Yoshihito Ide & Kohei Murata

  6. Department of Gastroenterological Surgery, Kagawa University Hospital, Kagawa, Japan

    Shintaro Akamoto

  7. Department of Surgery, Osaka Red Cross Hospital, Osaka, Japan

    Akiyoshi Kanazawa

  8. Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Masayoshi Nakanishi

  9. Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan

    Takeshi Naitoh

  10. Department of Surgery, Ageo Central General Hospital, Ageo, Japan

    Eiji Kanehira

  11. Department of Gastroenterological Surgery, St. Marianna University School of Medicine, Kawasaki, Japan

    Tsukasa Shimamura

  12. Department of Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Japan

    Ichio Suzuka

  13. Department of Surgery, Cancer Institute Ariake Hospital, Tokyo, Japan

    Yosuke Fukunaga

  14. National Hospital Organization Kyoto Medical Center, Kyoto, Japan

    Takashi Yamaguchi

  15. Department of Surgery, Kitasato University Hospital, Sagamihara, Japan

    Masahiko Watanabe

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  1. Seiichiro Yamamoto
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  2. Takao Hinoi
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Consortia

for the Japan Society of Laparoscopic Colorectal Surgery

  • Kunihisa Shiozawa
  • , Hiroyuki Bando
  • , Daisuke Yamamoto
  • , Seigo Kitano
  • , Masafumi Inomata
  • , Tomonori Akagi
  • , Junji Okuda
  • , Keitaro Tanaka
  • , Masayoshi Yasui
  • , Kosei Hirakawa
  • , Kiyoshi Maeda
  • , Junichi Hasegawa
  • , Junichi Nishimura
  • , Hiroya Kuroyanagi
  • , Hisanaga Horie
  • , Masaki Naito
  • , Takashi Ueki
  • , Yoshiharu Sakai
  • , Koya Hida
  • , Yousuke Kinjo
  • , Yukihito Kokuba
  • , Madoka Hamada
  • , Norio Saito
  • , Masaaki Ito
  • , Toshimasa Yatsuoka
  • , Jo Tashiro
  • , Shigeki Yamaguchi
  • , Tomohisa Furuhata
  • , Kenji Okita
  • , Yoshiro Kubo
  • , Shuji Saito
  • , Yusuke Kinugasa
  • , Fumio Konishi
  • , Kazuhiro Sakamoto
  • , Michitoshi Goto
  • , Junichi Tanaka
  • , Shungo Endo
  • , Nobuyoshi Miyajima
  • , Tadashi Suda
  • , Yoshihisa Saida
  • , Toshiyuki Enomoto
  • , Yasuhiro Munakata
  • , Ken Hayashi
  • , Souichi Tagami
  • , Yasumasa Takii
  • , Satoshi Maruyama
  • , Takao Ichihara
  • , Hitoshi Idani
  • , Kohei Kurose
  • , Yasuhiro Miyake
  • , Shoichi Hazama
  • , Shoichi Fujii
  • , Shigeru Yamagishi
  • , Kazuteru Watanabe
  • , Kenichi Sugihara
  •  & Shin Fujita

Corresponding author

Correspondence to Seiichiro Yamamoto.

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Conflict of interest

Seiichiro Yamamoto, Takao Hinoi, Hiroaki Niitsu, Masazumi Okajima, Yoshihito Ide, Kohei Murata, Shintaro Akamoto, Akiyoshi Kanazawa, Masayoshi Nakanishi, Takeshi Naitoh, Eiji Kanehira, Tsukasa Shimamura, Ichio Suzuka, Yosuke Fukunaga, Takashi Yamaguchi, and Masahiko Watanabe have no conflicts of interest or financial ties to disclose.

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Yamamoto, S., Hinoi, T., Niitsu, H. et al. Influence of previous abdominal surgery on surgical outcomes between laparoscopic and open surgery in elderly patients with colorectal cancer: subanalysis of a large multicenter study in Japan. J Gastroenterol 52, 695–704 (2017). https://doi.org/10.1007/s00535-016-1262-5

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  • DOI: https://doi.org/10.1007/s00535-016-1262-5

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