Shigeki Yamaguchi, MD, Seiichiro Yamamoto, MD, Junji Okuda, MD, Koki Otsuka, MD, Masanori Sugito, MD, Takashi Yamaguchi, MD, Yoshiharu Sakai, MD, Takatoshi Nakamura, MD, Kenichi Yoshimura, Masahiko Watanabe, MD
Saitama Medical University International Medical Center and the Japan Society of Laparoscopic Colorectal Surgery
INTRODUCTION: Gender is known as one of the risk factor of postoperative complication especially leakage after proctectomy. Multi-center prospective study had registered for 490 laparoscopic rectal cancer resections since 2008 to 2010. This study was accessed about difference of short term results between male and female for laparoscopic proctectomy.
PATIENTS AND METHODS: There were 281 males (M) and 110 females (F). Mean age was 59.6 each. BMI and prior abdominal operation were 23.3, 21.9 (p<0.01) and 16.4%, 32.5% (p<0.01), respectively. Mean tumor location from anal verge was 6.7 cm each. Procedures were anterior resection (AR): 79%, 86%, intersphincteric resection (ISR): 19%, 12%. Rates of pathological Stage 0/I were 70% and 66%, respectively. Student’s t test, the Mann-Whitney U test, Chi-square test, and Fisher’s exact test were used as appropriate.
RESULTS: Median operative time and blood loss were 283 min., 256 min. (p<0.01) and 35g, 20g (n.s.). Conversion rates were 1.8% (5 cases) and 1.4% (3 cases) (n.s.). Intraoperative organ injury and anastomotic trouble including rectal transection were 1.8%, 2.5% (n.s.) and 2.5%, 0.4% (p<0.05). There was no mortality in both gender. Postoperative complications occurred in 30.6% and 14.8% (p<0.001). Popular complications were as follows; wound complication: 13.2%, 3.3% (p<0.01), ileus: 8.5%, 2.9%(p<0.05), anastomotic leak of AR and ISR: 11.7%, 3.9% (p<0.01). Anastomotic leak of only AR was 11.8% (26/221) and 3.9% (7/179) (p<0.01). Median postoperative hospital stay was 12 and 11 days (p<0.01).
CONCLUSION: Male was risk factor of postoperative complications, especially anstomotic leak and wound complication in laparoscopic proctectomy.
Session: Podium Presentation
Program Number: S042