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Safety of Single-Site Laparoscopic Surgery Requiring Perioperative Heparinization in Colorectal Cancer: Propensity Score-Matched Analysis

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

A Correction to this article was published on 17 September 2019

This article has been updated

Abstract

Background

We assessed the feasibility and safety of single-site laparoscopic surgery for patients with colorectal cancer who required perioperative heparinization.

Methods

This retrospective study reviewed the medical records of 390 patients who underwent single-site laparoscopic surgery for colorectal cancer from January 2010 to December 2016. Antithrombotic drugs were stopped preoperatively and heparin was administered according to the operative risk of each patient, based on consultation with the cardiologist physician or neurosurgeon. Propensity score modeling was utilized to adjust for baseline characteristics.

Results

Of 390 patients, 29 were treated with standard bridging intravenous heparin therapy. Propensity matching identified 119 patients: 22 patients in the heparinization group and 97 in the control group. The matched groups were not significantly different in operation times, bleeding volumes, or conversion rate. The mean postoperative hospital stay was 17.9 days in the heparinization group and 9.5 days in the control group (p = 0.034). Postoperative bleeding was observed in 4 patients (18.2%) in the heparinization group and 11 patients (11.4%) in the control group (p = 0.646), while other complications were similar in the two study groups (p = 0.502). Of these other complications, thromboembolic events were observed in two patients in the heparinization group and one patient in the control group.

Conclusions

We found that single-site laparoscopic surgery for colorectal cancer with heparinization was feasible and safe. Heparinization did not increase the risk of postoperative bleeding complications, but postoperative hospital stay was prolonged.

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Change history

  • 17 September 2019

    In the original article, Yuichiro Doki’s first and last names are transposed. The author’s name is correct as reflected here.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

    Kazuya Iwamoto MD, Hidekazu Takahashi MD, Naotsugu Haraguchi MD, Taishi Hata MD, Chu Matsuda MD, Hirofumi Yamamoto MD, Tsunekazu Mizushima MD, Masaki Mori MD & Doki Yuichiro MD

  2. Department of Mathematical Health Science, Osaka University Graduate School of Medicine Division of Health Sciences, Osaka, Japan

    Makoto Fujii MD

  3. Department of Surgery and Science, Kyushu University Graduate School of Medical Sciences, Osaka, Japan

    Masaki Mori MD

Authors
  1. Kazuya Iwamoto MD
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  2. Hidekazu Takahashi MD
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  3. Makoto Fujii MD
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  4. Naotsugu Haraguchi MD
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  5. Taishi Hata MD
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  6. Chu Matsuda MD
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  7. Hirofumi Yamamoto MD
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  8. Tsunekazu Mizushima MD
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  9. Masaki Mori MD
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  10. Doki Yuichiro MD
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Corresponding author

Correspondence to Hidekazu Takahashi MD.

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Disclosure

Kazuya Iwamoto, Hidekazu Takahashi, Makoto Fujii, Naotsugu Haraguchi, Taishi Hata, Chu Matsuda, Hirofumi Yamamoto, Tsunekazu Mizushima, Masaki Mori, and Doki Yuichiro declare no conflicts of interest.

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Supplementary Fig. 1

Representative case of laparoscopic surgery for advanced ascending colon cancer. (a) A 3 cm, single laparotomy was performed; (b) the CME was definitively completed; and (c) a central vascular ligation was performed at the root of the ileocolic artery and vein. (d) The resected specimen also shows that CME was properly completed. CME complete mesocolic excision (TIFF 1298 kb)

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Iwamoto, K., Takahashi, H., Fujii, M. et al. Safety of Single-Site Laparoscopic Surgery Requiring Perioperative Heparinization in Colorectal Cancer: Propensity Score-Matched Analysis. Ann Surg Oncol 26, 4390–4396 (2019). https://doi.org/10.1245/s10434-019-07794-x

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  • DOI: https://doi.org/10.1245/s10434-019-07794-x

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