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Safety of Laparoscopic Colorectal Resection in Patients With Severe Comorbidities

Ichikawa, Nobuki MD; Homma, Shigenori PhD; Nakanishi, Kazuaki PhD; Kazui, Keizo PhD; Kashiwakura, Sayuri MD; Ohira, Masafumi MD; Tsuji, Takeshi MD; Suzuki, Takashi MD; Ishikawa, Tomohiro MD; Taketomi, Akinobu PhD

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: December 2016 - Volume 26 - Issue 6 - p 503–507
doi: 10.1097/SLE.0000000000000333
Original Articles
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We aimed to assess the safety of laparoscopic colorectal resection in patients with severe comorbidities. High operative risk was defined as an American Society of Anesthesiologists (ASA) class 3 score. Outcomes in 34 patients with an ASA score of 3 undergoing laparoscopic surgery (LAP3) were compared with 172 laparoscopic surgery patients with an ASA score ≤2 (LAP2) and 32 laparotomy patients with an ASA score of 3 (OP3). The postoperative complication rate in LAP3 was similar to that seen in LAP2 and significantly lower than that seen in OP3 (LAP2, 4.0%; LAP3, 5.9%; OP3, 31.2%). The incidence of postoperative hemorrhage, infection, ileus, and anastomotic leakage was similar between LAP3 and LAP2 and between LAP3 and OP3. However, the systemic complication rate in LAP3 was similar to that seen in LAP2 and significantly lower than that seen in OP3. Laparoscopic colorectal resection can be performed safely in patients with severe comorbidities.

*Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University

Department of Surgery, Hokkaido Hospital, Japan Community Health Care Organization, Sapporo

Department of Surgery, Iwamizawa Municipal General Hospital, Iwamizawa, Japan

The authors declare no conflicts of interest.

Reprints: Nobuki Ichikawa, MD, Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, N-15, W-7, Kita-ku, Sapporo 060-8638, Japan (e-mail: n_ichi@d5.dion.ne.jp).

Received February 23, 2016

Accepted September 26, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.