Laparoscopic Colorectal Resection for High Risk Patients

Abstract

Introduction: Laparoscopic colectomy has been proven to be an accepted option for the treatment of colorectal cancer. Its application in high-risk patients is still controversial. This study reviewed the outcome of high-risk patients who underwent laparoscopic resection for colorectal neoplasm.

Methods: During the study period, data on patients with colorectal resection were collected propectively. In this study, patients who were of ASA (American Society of Anesthesiologists) Class 3 or above, and underwent laparoscopic resection (LR) for colorectal neoplasm were included. The outcomes of surgery were analyzed and compared with those who underwent open operation (OR).

Results: One hundred and thirteen patients (68 men) with a median age of 76.5 years (range 53 – 90) were in the LR group. Seventeen of them had previous treatment for other malignancies and 87.6% of patients had concomitant medical diseases. The median was 120ml and transfusion was required in 7 patients. Conversion was required in 16 patients (14.2%). The median postoperative hospital stay was 6 days (IRQ: 4-9 days). The operative mortality (30 days) was 0.9% and the overall complication rate was 23.9%. When compared with the 230 patients in the OR group, there were no differences in age, gender, site of the tumor, the presence of medical disease, the stage of the cancer and operative mortality. However, complication rate was significantly lower in the LR group (23.9% versus 38.3%, p=0.01) and hospital stay was also shorter ( 6 days versus 8 days, p ......