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Tumor Size as an Independent Risk Factor for Postoperative Complications in Laparoscopic Low Anterior Resection for Advanced Rectal Cancer: A Multicenter Japanese Study

Yasui, Masayoshi MD, PhD; Takemasa, Ichiro MD, PhD; Miyake, Yuichiro MD, PhD; Hata, Taishi MD, PhD; Ikeda, Masataka MD, PhD; Miyake, Yasuhiro MD, PhD; Hasegawa, Junichi MD, PhD; Ota, Hirofumi MD, PhD; Matsuda, Chu MD, PhD; Mizushima, Tsunekazu MD, PhD; Doki, Yuichiro MD, PhD; Mori, Masaki MD, PhDOn behalf of the Clinical Study Group of Osaka University (CSGO), Colorectal Group

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: April 2017 - Volume 27 - Issue 2 - p 98–103
doi: 10.1097/SLE.0000000000000377
Original Articles

This study aimed to identify the risk factors for postoperative complications after laparoscopic low anterior resection for the treatment of advanced rectal cancers. A prospectively maintained database was retrospectively analyzed. Oncological parameters in resected specimens and clinical risk factors for postoperative complications, including anastomotic leakage, were examined in patients with clinical stage II and III upper rectal cancer who underwent laparoscopic low anterior resection, including total mesorectal excision. Pathologic resection margins were negative in all patients. Postoperative complications occurred in 22 patients (25.9%), which is similar to incidence rates in previous studies. In multivariate analysis, tumor size (≥4 cm) and tumor category (T4) were independent risk factors for postoperative complications. Precise pretreatment diagnoses with locoregional evaluations are essential for the selection of appropriate patients for laparoscopic rectal resection. Despite quality results from laparoscopic low anterior resection for the treatment of advanced rectal cancer, we must attempt to reduce postoperative complications.

*Department of gastroenterological surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases

§Department of surgery, National Hospital Organization, Osaka National Hospital

**Department of surgery, Osaka General Medical Center, Osaka City

Department of gastroenterological surgery, Osaka University Graduate School of Medicine, Suita City

Department of surgery, Osaka Rosai Hospital, Sakai City

#Department of surgery, Ikeda City Hospital, Ikeda City, Osaka

Department of surgery, Nishinomiya Municipal Central Hospital, Nishinomiya City, Hyogo

Department of surgery, surgical oncology and science, Sapporo Medical University, Hokkaido

M.Y. and I.T. contributed equally.

The authors declare no conflicts of interest.

Reprints: Masayoshi Yasui, MD, PhD, Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases 1-3-3 Nakamichi, Higashinari-ku, Osaka city, Osaka 537-8511, Japan (e-mail:

Received March 24, 2016

Accepted December 30, 2016

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.