title: Is laparoscopic surgery a contraindication in patients with severe senile kyphosis?
abstract: OBJECTIVE
  The japanese population have the longest-life expectancy in the world. Accordingly, older patients with colorectal cancer with senile kyphosis caused by aging or osteoporosis also increase. Laparoscopic surgery is minimally-invasive, and performance on severe kyphotic patients may cause difficulty to approach a narrow abdomen. To determine whether laparoscopic surgery is safe and feasible in patients with severe senile kyphosis.
  
  
  METHODS
  Laparoscopic operations under general anesthesia were undertaken with the patients in lithotomy position. Intraoperative difficulties were compared with normal laparoscopic approach.
  
  
  RESULTS
  Working space was divided by right costal arch during right hemicolectomy for right sided colon cancer. For sigmoid colon cancer, dissection of lymph node and anastomosis were completed with much difficulty because the pelvic space was occupied with small intestine. However, the postoperative course was uneventful despite impaired lung function in all cases.
  
  
  CONCLUSIONS
  Severe senile kyphosis is not a contraindication for minimally invasive technique applied to colorectal cancer patients.
authors.affiliation: Gastroenterological Surgery, Gastrointestinal Center, Comprehensive Cancer Center, Saitama Medical University International Medical Center 1397-1 Yamane, Hidaka 350-1298, Japan. satoaogp@saitama-med.ac.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sato
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Shutaro
authors.initials: S
authors.lastname: Ozawa
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Ishii
authors.forename: Jo
authors.initials: J
authors.lastname: Tashiro
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hosonuma
authors.forename: Isamu
authors.initials: I
authors.lastname: Koyama
authors.forename: Michel
authors.initials: M
authors.lastname: Gagner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000601:surgery*; D000075202:Contraindications; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000150:complications*; D010535:Laparoscopy; D019060:Minimally Invasive Surgical Procedures