Risk factors preventing success of a minilaparotomy approach in the resection of colorectal cancer.
BACKGROUND
A minilaparotomy approach is technically feasible for the resection of colorectal cancer in select patients. The aim of this study was to clarify the risk factors preventing the success of a minilaparotomy in the resection of colorectal cancer.


METHODS
Between April 2005 and August 2008, 141 consecutive patients were enrolled in this prospective study and scheduled to undergo resection of colorectal cancer using a minimal skin incision. The minilaparotomy involved a colorectal resection performed through a skin incision <7 cm in length. Neither a hand-port nor a laparoscope was used.


RESULTS
A minilaparotomy was successful in 74 (52.5%) of 141 patients. Multivariate logistic regression analysis revealed that the failure of the minilaparotomy in the remaining 67 (47.5%) was independently related to gender (male), BMI (> or =25.5), tumor location (splenic flexure and rectum), tumor adhesion/invasion on/into adjacent organs and the maximum tumor diameter (> or =7.0 cm).


CONCLUSIONS
Gender (male), BMI (> or =25.5), tumor location (splenic flexure and rectum) and tumor aggressiveness [tumor adhesion/invasion on/into adjacent organs and maximum tumor diameter (> or =7.0 cm)] were independent risk factors preventing the success of the minilaparotomy approach in the resection of colorectal cancer.
Nakagoe
Tohru
T
Department of Surgery, Ohmura Municipal Hospital, 133-22 Kogashima-cho, Ohmura-city, Nagasaki, Japan. nakagoe-t@jadecom.or.jp
Matsuo
Toshikazu
T
Nakamura
Shirou
S
Ryu
Chusei
C
Murakami
Goushi
G
Arisawa
Kokichi
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007813:Laparotomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D016896:Treatment Outcome