Laparoscopic resection for colorectal cancer

Buchanan, G. N.; Malik, Arshad H.; Parvaiz, Amjad; Sheffield, J. P.; Kennedy, Robin H.

doi:10.1002/bjs.6019

Cited by 63 publications

(55 citation statements)

References 26 publications

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“…Nonetheless, within the obese group, there are patients who are undoubtedly more challenging. While some centres report laparoscopic completion rates of over 90% overall 15 we found a conversion rate of 16%, rising to 27% in the obese group using a strict definition of conversion as any incision larger than that required to extract the specimen. There was a statistically higher AFR in patients in the obese group who underwent conversion, but not a statistically significantly higher BMI.…”

Section: Discussioncontrasting

confidence: 56%

Abdominal fat ratio – a novel parameter for predicting conversion in laparoscopic colorectal surgery

Farid

Mann

et al. 2017

annals

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INTRODUCTION Laparoscopic surgery has become the standard for colorectal cancer resection in the UK but it can be technically challenging in patients who are obese. Patients whose body fat is mainly inside the abdominal cavity are more challenging than those whose fat is mainly outside the abdominal cavity. Abdominal fat ratio (AFR) is a simple parameter proposed by the authors to aid identification of this subgroup. MATERIALS AND METHODS All 195 patients who underwent elective, laparoscopic colorectal cancer resections from March 2010 to November 2013 were included in the study. For patients who were obese (body mass index greater than 30), preoperative staging computed tomography was used to determine AFR. This was assessed by two different, blinded observers and compared with conversion rate. RESULTS Of the 195 patients, 58 (29.7%) fell into the obese group and 137 (70.3%) into the non-obese group. The median AFR of the obese group that were converted to open surgery was significantly higher at 5.9 compared with those completed laparoscopically (3.3, P = 0.0001, Mann-Whitney). There was no significant difference in conversion rate when looking at body mass index, tumour site or size. DISCUSSION Previous studies have found body mass index, age, gender, previous abdominal surgery, site and locally advanced tumours to be associated with an increased risk of conversion. This study adds AFR to the list of risk factors. CONCLUSION AFR is a simple, reproducible parameter which can help to predict conversion risk in obese patients undergoing colorectal cancer resection.

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Section: Discussioncontrasting

confidence: 56%

Abdominal fat ratio – a novel parameter for predicting conversion in laparoscopic colorectal surgery

Farid

Mann

et al. 2017

annals

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“…Colorectal cancer is presently the third most common malignancy in Korea, and the rate is still increasing [14]. The use of laparoscopic resection of colorectal cancer has also increased [15,16], including in Asian obese patients. Studies in Western populations have shown that obese patients undergoing laparoscopic colorectal surgery are at increased risk of conversion to an open procedure [1][2][3]17].…”

Section: Discussionmentioning

confidence: 99%

The impact of obesity on outcomes of laparoscopic surgery for colorectal cancer in Asians

et al. 2009

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“…Amount of lymph nodes harvested ranged from 0 to 68, with average 12.27 ± 9.02, which had met the criteria of conventional open radical operation. In the study of Buchanan et al (2008), the number of lymph nodes harvested ranged from 0 to 24, with average 9, in which 135 patients had accepted conventional open surgery. The radical efficacy of laparoscopic colorectal operation is evaluated in terms of local recurrence, metastasis, wound plantation and long-term survival.…”

Section: Radical Efficacy Of Laparoscopic Colorectal Surgerymentioning

confidence: 99%

Laparoscopic Colorectomy for Colorectal Cancer: Retrospective Analysis of 889 Patients in a Single Center

Lü

Zhou

Xun

et al. 2012

Tohoku J. Exp. Med.

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Laparoscopic colectomy has been reported as an alternative for treatment of colorectal cancer. However, its long-term efficacy and safety remain obscure. The purpose here was to review our experience with laparoscopic colectomy in 899 patients between June 2001 and December 2008. Of them, 43 patients were converted to open surgery and 846 accepted laparoscopic colorectomy successfully. Among these 846 patients, 790 patients underwent radical resection and 56 patients underwent palliative resection. Only 1 patient died from perioperative pulmonary infection; thus the mortality was 0.12% (1/846). The morbidity of perioperative complications was 18.20% (154/846): intraoperative complication rate was 4.49% (38/846) and the most common intraoperative complication was subcutaneous emphysema and hypercapnia (1.65%, 14/846); postoperative complication rate was 13.71% (116/846) and the most common postoperative complication was ileus (4.37%, 37/846). The overall followed-up rate was 86.41% (731/846, 680 for radical operations and 51 palliative operations). Postoperative deaths happened to 139 patients, including 112 after radical operation and 27 after palliative resection. Of these 112 patients, 97 deaths were cancer-related (14.26%, 97/680) and 15 deaths were non-cancer-related. There were 10 patients encountered local recurrence (1.47%, 10/680) and 105 for metastasis (15.44%, 105/680) after radical operation. Forty-two patients are still alive with tumor. Overall survival rate was 80.98% (592/731), 3-year disease-free survival (DFS) rate after radical operation was 78.0%, and 3-year DFS rate after radical operation for stage I, stage II, and stage III was 89.0%, 85.0%, and 65.0%, respectively. In conclusion, laparoscopic colorectal resection is a feasible and safe technology for colorectal cancer.

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Laparoscopic resection for colorectal cancer

Abstract: With experience, laparoscopic surgery is feasible in around 90 per cent of elective colorectal cancer resections.

Cited by 63 publications

References 26 publications

Abdominal fat ratio – a novel parameter for predicting conversion in laparoscopic colorectal surgery

Abdominal fat ratio – a novel parameter for predicting conversion in laparoscopic colorectal surgery

The impact of obesity on outcomes of laparoscopic surgery for colorectal cancer in Asians

Laparoscopic Colorectomy for Colorectal Cancer: Retrospective Analysis of 889 Patients in a Single Center

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