Toru Tonooka, Nobuhiro Takiguchi, Yoshihiro Nabeya, Wataru Takayama, Atsushi Ikeda, Hiroaki Soda, Satoshi Chiba, Isamu Hoshino, Hidehito Arimitsu, Hiroo Yanagibashi, Tomofumi Chibana, Yusuke Hanzawa, Matsuo Nagata. Chiba Cancer Center
Aim: Difficulty in laparoscopic surgery increases depending on the degree of obesity. Especially, in the transverse colon cancer surgery, not only lymph node dissection along with the vessels, but also the anastomosis reconstruction procedure is greatly affected by the degree of obesity. The aim of this study is to verify the relationship between the degree of obesity and the level of difficulty in the anastomosis reconstruction of laparoscopic transverse colon surgery.
Method: Thirteen patients who underwent laparoscopic partial colon resection for the transverse colon cancer in our department in the period of April 2006 to June 2013 were enrolled. The body mass index (BMI) and the visceral fat area (VFA) were calculated and assessed with the surgery-related factors, particularly with the reconstruction-related factors to see the effects on the surgery difficulty.
Results: The BMI had a tendency of correlation with the duration of operation time (correlation coefficient; r = 0.542, p = 0.055) and the length of the skin incision (r = 0.558, p = 0.047). Similarly, the VFA showed a trend of correlation with the operation time (r = 0.538, p = 0.071) and the skin incision length (r = 0.75, p = 0.005). There was no correlation with other surgery-related factors, such as the amount of blood loss, the extent of dissection mobilization area, the vascular ligation site, the skin incision site, the anastomosis methods, the amount of lymph node dissection, the postoperative complications, and the postoperative hospital stay. Six patients (46.2%) required the incision at the epigastrium instead of the umbilical region. Also, the hand-sawn end-to-end anastomosis, rather than the functional end-to-end stapling, was adopted in 9 patients (69.2%).
Conclusion: In laparoscopic surgery for transverse colon cancer, extension of the skin incision and prolongation of the surgery time was required in accordance with the degree of obesity. In order to perform secure anastomosis reconstruction, skin incision site of the abdominal wall, length of skin incision, and the selection of the anastomosis method is important in the laparoscopic transverse colon cancer resection.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80235
Program Number: P260
Presentation Session: Poster (Non CME)
Presentation Type: Poster
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