Shinobu Ohnuma, Hideaki Karasawa, Kazuhiro Watanabe, Takahiro Tsuchiya, Hirofumi Imoto, Takeshi Aoki, Naoki Tanaka, Katsuyoshi Kudoh, Tomoya Abe, Munenori Nagao, Hiroaki Musha, Fuyuhiko Motoi, Takeshi Naitoh, Michiaki Unno. Tohoku University Hospital
INTRODUCTION – Laparoscopic surgery in patients with previous abdominal operations is considered as a relative contraindication because of concern for the presence of adhesions and risk of injury. The aim of this study is to evaluate how previous abdominal operations influence the outcome of the patients with laparoscopic colorectal surgery (LAC) for colorectal cancer (CRC).
METHODS AND PROCEDURES – Total 237 patients who had LAC for CRC in Tohoku University Hospital from 2008 to 2016 were retrospectively analyzed by comparing perioperative factors of the patients with previous abdominal operations (n = 101, group A) to those of the patients without any history of operations (n = 136, group B).
RESULTS – In group A, the frequencies of previous abdominal operations were one-time: 83, two-times: 15, three-times: 3, respectively. Operative procedures were appendectomy: 70, gynecologic surgery: 27, cholecystectomy: 9, urologic surgery: 6, colectomy: 4, gastrectomy: 3, abdominal aortic aneurysm repair: 2, respectively. In perioperative factors, there are no statistically difference between group A and B in terms of blood-loss (25 vs 25 ml, p = 0.37), operative time (204 vs 206 min, p = 0.48), hospital-length of stay after surgery (11 vs 10 days, p = 0.43), and incidence of complications (7.0 vs 10.3%; Clavien-Dindo grade > or = 2). In group A, however, there was a trend for increasing operative time of patients with history of three-time operations (282 vs 206 min) and of colectomy (237 vs 206 min). In this study, three cases (1.3%) of conversion from laparoscopic to open surgery were observed, and two of three had previous abdominal operations which included a case of abdominal total hysterectomy with lymphnodes dissection for uterine cancer and a case of cholecystectomy for cholecystolithiasis with peritonitis.
CONCLUSIONS – Most cases of LAC for CRC patients with previous abdominal operations might safely be completed. However, it should carefully be performed in the patients with previous histroy of multiple abdominal operations, colectomy, gynecological operation with lymphnodes dissection for malignancy, and operation for disease with peritonitis.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80826
Program Number: P208
Presentation Session: Poster (Non CME)
Presentation Type: Poster