title: Efficacy of laparoscopic colorectal resection for risk patients with severe comorbidity.
abstract: OBJECTIVE
  This study assessed the short term results of laparoscopic colorectal resection for high risk patients.
  
  
  METHODS
  Five hundred and fifty seven consecutive patients underwent an elective laparoscopic colorectal cancer resection by the same surgical team between April 2007 and December 2010. No risk patients in ASA class 1 (Group N, n=222), low risk patients with the systemic disease under the control in ASA class 2 and 3 (Group L, n=320), high risk patients with severe comorbidities in ASA class 4 (Group H, n=15) were respectively compared.
  
  
  RESULTS
  The median blood loss count was significantly higher than the other group (N: 26 g, L: 22 g) in group H (59 g; p<0.05). On the other hands, the less lymphadenectomy was performed and a reconstruction with anastomosis was denied in group H. The incidence of postoperative complications was not significantly different in each group (N: 12%, L: 18%, H: 26%; p>0.05). There was the significant difference of the incidence with systemic complication (respiratory failure, ascites and delirium) in group H. The median postoperative hospital stay was not significantly different in each group (POD7; p>0.05). Hospitalization death occurred in three patients (0.5%) by uncontrollability of the systemic disease, two patients in group L and one patient in group H.
  
  
  CONCLUSIONS
  Laparoscopic colorectal resection for high risk patients was performed safely without increasing complications and postoperative hospital stay.
authors.affiliation: Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, Saitama, Japan. tashiro@saitama-med.ac.jp
authors.forename: Jo
authors.initials: J
authors.lastname: Tashiro
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Ishii
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Suwa
authors.forename: Ichirou
authors.initials: I
authors.lastname: Okada
authors.forename: Hiroka
authors.initials: H
authors.lastname: Kondo
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Miyazawa
authors.forename: Nozomi
authors.initials: N
authors.lastname: Shinozuka
authors.forename: Isamu
authors.initials: I
authors.lastname: Koyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome