title: Safety of Laparoscopic Colorectal Resection in Patients With Severe Comorbidities.
abstract: We aimed to assess the safety of laparoscopic colorectal resection in patients with severe comorbidities. High operative risk was defined as an American Society of Anesthesiologists (ASA) class 3 score. Outcomes in 34 patients with an ASA score of 3 undergoing laparoscopic surgery (LAP3) were compared with 172 laparoscopic surgery patients with an ASA score ≤2 (LAP2) and 32 laparotomy patients with an ASA score of 3 (OP3). The postoperative complication rate in LAP3 was similar to that seen in LAP2 and significantly lower than that seen in OP3 (LAP2, 4.0%; LAP3, 5.9%; OP3, 31.2%). The incidence of postoperative hemorrhage, infection, ileus, and anastomotic leakage was similar between LAP3 and LAP2 and between LAP3 and OP3. However, the systemic complication rate in LAP3 was similar to that seen in LAP2 and significantly lower than that seen in OP3. Laparoscopic colorectal resection can be performed safely in patients with severe comorbidities.
authors.affiliation: *Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University †Department of Surgery, Hokkaido Hospital, Japan Community Health Care Organization, Sapporo ‡Department of Surgery, Iwamizawa Municipal General Hospital, Iwamizawa, Japan.
authors.forename: Nobuki
authors.initials: N
authors.lastname: Ichikawa
authors.forename: Shigenori
authors.initials: S
authors.lastname: Homma
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Keizo
authors.initials: K
authors.lastname: Kazui
authors.forename: Sayuri
authors.initials: S
authors.lastname: Kashiwakura
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ohira
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsuji
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome