title: [Laparoscopic Surgery for T4b Colorectal Cancer].
abstract: BACKGROUND
  It is considered difficult to perform laparoscopic surgery for colorectal cancer with T4b that is directly invades to adjacent organs. This retrospective study evaluated pT4b colorectal cancer in terms of the efficacy of laparoscopic surgery.
  
  
  RESULTS
  Forty-six cases with pT4b colorectal cancer that occurred between 2006 and 2014 were investigated. Laparoscopic surgery (LAC) was performed in 20 cases, of which 5 were conversions, and open surgery (OC) was performed in 26 cases. Pathologically-proven invaded organs resected by LAC were the abdominal wall (n=6), greater omentum (n=5), small intestine or colon (n=3), bladder, appendix, or ovary (n=1). Organs resected by OC were the abdominal wall (n=8), bladder (n=5), colon, greater omentum, or small intestine (n=3), stomach, ovary, spermatic duct (concurrent with bladder), prostate, or sacrum (n=1). Operation time (median) was 275 min for LAC and 260 min for OC. Blood loss (median) was 100 mL for LAC and 410 mL for OC. The duration of hospital stay (median) was 15 days after LAC and 18 days after OC. There were 2 cases with morbidities greater than Grade 3 after LAC and 1 case after OC. There was 1 hospital death in the OC group.
  
  
  CONCLUSIONS
  Laparoscopic surgery for T4b colorectal cancer can be feasible in select cases.
authors.affiliation: Dept. of Surgery, Suita Municipal Hospital.
authors.forename: Kohei
authors.initials: K
authors.lastname: Murata
authors.forename: Youichirou
authors.initials: Y
authors.lastname: Nushijima
authors.forename: Shu
authors.initials: S
authors.lastname: Okamura
authors.forename: Rie
authors.initials: R
authors.lastname: Hamano
authors.forename: Nariaki
authors.initials: N
authors.lastname: Fukuchi
authors.forename: Chikara
authors.initials: C
authors.lastname: Ebisui
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Kinuta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome