Laparoscopic colorectal surgery for neoplasm. A large series by a single surgeon

Fukunaga, Yosuke; Higashino, Masayuki; Tanimura, Sinya; Takemura, Masashi; Osugi, Harushi

doi:10.1007/s00464-007-9630-0

Cited by 14 publications

(14 citation statements)

References 21 publications

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“…Adhesions were significantly more common as a cause of conversion in S group patients than in non-S group patients. A relatively low rate of conversion to laparotomy was reported for a series performed by a single surgeon with considerable experience of this procedure [10], but there was still an increase in conversion due to adhesions in the patients with previous abdominal surgery. This was expected, but our conversion rate was lower compared with those reported previously.…”

Section: Discussionmentioning

confidence: 99%

“…Morbid obesity (BMI >35 kg/m 2 ), tumors occupying most of the pelvic space, and advanced rectal cancer located below the peritoneal reflection and requiring lateral lymph node dissection were absolute contraindications. The standard laparoscopic procedure used at our institution involved pneumoperitoneum and 4 or 5 ports, as has been reported previously [10]. …”

Section: Methodsmentioning

confidence: 99%

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Laparoscopic Colorectal Surgery in Patients with Prior Abdominal Surgery

Fukunaga

Kameyama²,

Kawasaki³

et al. 2011

Dig Surg

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Purpose: We retrospectively investigated the impact of prior abdominal surgery on the outcome of laparoscopic colorectal surgery. Patients: Among 607 colorectal cancer patients who underwent laparoscopic surgery, 192 patients had previously undergone abdominal surgery (S group) and 415 had not (non-S group). Results: The percentage of female patients was higher in the S group than in the non-S group. The incidence of conversion to open surgery was higher in the S group (5.2%, 10/192) than in the non-S group (2.6%, 11/415), but the difference was not significant (p = 0.108). Although the mean operating time and estimated blood loss were similar in the two groups, right and transverse colectomy after prior gastrectomy and ipsilateral colectomy after prior colectomy took longer and were associated with greater blood loss. The morbidity rates of the two groups were similar (S group: 15.6%, 30/192; non-S group: 14.5%, 60/415). There were 5 intraoperative small-bowel injuries or postoperative small-bowel perforations in the S group, especially in the patients with prior gastrointestinal-tract surgery. Conclusion: Our findings suggest that there is no reason to avoid laparoscopic procedures in most patients with prior abdominal surgery despite a higher conversion rate, but caution is warranted in patients who have undergone major gastrointestinal-tract surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Laparoscopic Colorectal Surgery in Patients with Prior Abdominal Surgery

Fukunaga

Kameyama²,

Kawasaki³

et al. 2011

Dig Surg

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“…Specific exclusion criteria for clinical stage IV patients were massive ascites due to peritoneal seeding, malnourishment, performance status [2, and inability to tolerate general anesthesia for a laparoscopic procedure in Trendelenburg position with 10 mmHg pneumoperitoneum. The standard laparoscopic procedure at our institution was done under pneumoperitoneum with four or five ports, as reported previously [25].…”

Section: Methodsmentioning

confidence: 99%

Laparoscopic surgery for stage IV colorectal cancer

et al. 2009

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“…LCR is believed to be technically more difficult than open surgery and thought to require more intensive training to ensure safe and oncologic operation [6,7]. There are many reports regarding the learning curve for performing LCR [7][8][9][10][11][12][13][14][15]. The learning curve is generally accepted to be approximately 30 procedures based on decline in operative time, intraoperative complications, and conversion rate.…”

Section: Introductionmentioning

confidence: 99%