title: Safety of Laparoscopic Pelvic Exenteration with Urinary Diversion for Colorectal Malignancies.
abstract: BACKGROUND
  Although the feasibility of laparoscopic surgery for colorectal cancer has been demonstrated, the safety of laparoscopic pelvic exenteration (PE) with urinary diversion for colorectal malignancies remains poorly studied. The present study aimed to examine the safety and feasibility of laparoscopic PE in patients with colorectal malignancies.
  
  
  METHODS
  Thirty-one consecutive patients who underwent anterior or total PE with urinary diversion for colorectal malignancies between July 2004 and April 2015 at our institution were included in the study. Perioperative outcomes were compared between patients undergoing laparoscopic (n = 13) and open (n = 18) PE.
  
  
  RESULTS
  There were no conversions to open surgery. The estimated blood loss (930 vs. 3003 ml; P = 0.001) and total volume of blood transfusion (0 vs. 1990 ml; P = 0.002) were significantly lower in patients undergoing laparoscopic compared with open PE. R0 resection was performed in all patients. The operation time (laparoscopic, 829 min vs. open, 875 min; P = 0.660), complication rate (laparoscopic, 61.5 % vs. open, 83.3 %; P = 0.171), and postoperative hospital days (laparoscopic, 29 days vs. open, 33 days; P = 0.356) were similar in both groups. Three patients undergoing laparoscopic PE readmitted within 30 days due to ileus, although the rate of readmission did not differ significantly (laparoscopic, 23.1 % vs. open, 5.6 %; P = 0.284).
  
  
  CONCLUSIONS
  Laparoscopic PE performed by experienced laparoscopic pelvic surgeons should be considered as a safe and preferred option in selected patients with colorectal malignancies, with a significant advantage in terms of reduced blood loss compared with open surgery.
authors.affiliation: Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ogura
authors.affiliation: Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan. takashi.akiyoshi@jfcr.or.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Akiyoshi
authors.affiliation: Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Konishi
authors.affiliation: Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Fujimoto
authors.affiliation: Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nagayama
authors.affiliation: Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Fukunaga
authors.affiliation: Department of Gastroenterological Surgery, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31, Ariake, Koto-ku, Tokyo, 135-8550, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Ueno
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D061887:Conversion to Open Surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010385:Pelvic Exenteration / Q000379:methods*; D012449:Safety; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000379:methods*