BACKGROUND: Laparoscopic colon resection for left-sided colon cancer is being performed with increasing frequency worldwide. The purpose of this study is to evaluate the influence of patient- and procedure-related factors on difficulty of laparoscopic surgery for left-sided colon cancer. METHODS: Two hundred sixty consecutive patients underwent laparoscopic surgery for left-sided colon cancer from July 2005 to December 2008. Gender, body mass index (BMI), tumor location, tumor size, previous abdominal surgery, tumor depth, tumor stage, splenic flexure mobilization, type of anastomosis, and site of arterial division were analyzed as potential variables that affect difficulty of laparoscopic surgery. Dependent variables were operative time, intraoperative blood loss, intra- and postoperative complications, and proximal and distal tumor margin. Univariate and multivariate analyses were performed to determine predictive significance of variables. RESULTS: Multivariate analysis showed that male gender (P = 0.0183) and splenic flexure mobilization (P < 0.0001) were independently predictive of longer operative time. Splenic flexure mobilization was related to greater intraoperative blood loss (P = 0.0006), intraoperative complications (P = 0.0111, odds ratio: 7.22), and wider distal tumor margin (P = 0.0048). CONCLUSIONS: Male gender and splenic flexure mobilization were independent predictors of difficulty of laparoscopic surgery for left-sided colon cancer. In contrast, our findings also showed that BMI, tumor location, previous abdominal surgery, tumor stage, type of anastomosis, and site of arterial division did not have an adverse impact on difficulty of laparoscopic surgery for left-sided colon cancer in our clinical setting. Our data support the safety of performing laparoscopic surgery for left-sided colon cancer in well-selected patients by well-experienced surgical teams.
BACKGROUND: Laparoscopic colon resection for left-sided colon cancer is being performed with increasing frequency worldwide. The purpose of this study is to evaluate the influence of patient- and procedure-related factors on difficulty of laparoscopic surgery for left-sided colon cancer. METHODS: Two hundred sixty consecutive patients underwent laparoscopic surgery for left-sided colon cancer from July 2005 to December 2008. Gender, body mass index (BMI), tumor location, tumor size, previous abdominal surgery, tumor depth, tumor stage, splenic flexure mobilization, type of anastomosis, and site of arterial division were analyzed as potential variables that affect difficulty of laparoscopic surgery. Dependent variables were operative time, intraoperative blood loss, intra- and postoperative complications, and proximal and distal tumor margin. Univariate and multivariate analyses were performed to determine predictive significance of variables. RESULTS: Multivariate analysis showed that male gender (P = 0.0183) and splenic flexure mobilization (P < 0.0001) were independently predictive of longer operative time. Splenic flexure mobilization was related to greater intraoperative blood loss (P = 0.0006), intraoperative complications (P = 0.0111, odds ratio: 7.22), and wider distal tumor margin (P = 0.0048). CONCLUSIONS: Male gender and splenic flexure mobilization were independent predictors of difficulty of laparoscopic surgery for left-sided colon cancer. In contrast, our findings also showed that BMI, tumor location, previous abdominal surgery, tumor stage, type of anastomosis, and site of arterial division did not have an adverse impact on difficulty of laparoscopic surgery for left-sided colon cancer in our clinical setting. Our data support the safety of performing laparoscopic surgery for left-sided colon cancer in well-selected patients by well-experienced surgical teams.
Authors: Pierre J Guillou; Philip Quirke; Helen Thorpe; Joanne Walker; David G Jayne; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: Lancet Date: 2005 May 14-20 Impact factor: 79.321
Authors: Heidi Nelson; Daniel J Sargent; H Sam Wieand; James Fleshman; Mehran Anvari; Steven J Stryker; Robert W Beart; Michael Hellinger; Richard Flanagan; Walter Peters; David Ota Journal: N Engl J Med Date: 2004-05-13 Impact factor: 91.245
Authors: Peter J Hewett; Randall A Allardyce; Philip F Bagshaw; Christopher M Frampton; Francis A Frizelle; Nicholas A Rieger; J Shona Smith; Michael J Solomon; Jacqueline H Stephens; Andrew R L Stevenson Journal: Ann Surg Date: 2008-11 Impact factor: 12.969
Authors: R M Carlson; P L Roberts; J F Hall; P W Marcello; D J Schoetz; T E Read; R Ricciardi Journal: Tech Coloproctol Date: 2013-08-02 Impact factor: 3.781
Authors: A Ogura; R Kobayashi; T Aritake; T Maeda; K Kawai; K Takagi; S Kawai; S Kamiya Journal: Tech Coloproctol Date: 2019-05-29 Impact factor: 3.781
Authors: Felipe Quezada-Diaz; Rosa M Jimenez-Rodriguez; Kelly Rawdon; Julio Garcia-Aguilar Journal: Dis Colon Rectum Date: 2019-02 Impact factor: 4.585