title: Tumor Size as an Independent Risk Factor for Postoperative Complications in Laparoscopic Low Anterior Resection for Advanced Rectal Cancer: A Multicenter Japanese Study.
abstract: This study aimed to identify the risk factors for postoperative complications after laparoscopic low anterior resection for the treatment of advanced rectal cancers. A prospectively maintained database was retrospectively analyzed. Oncological parameters in resected specimens and clinical risk factors for postoperative complications, including anastomotic leakage, were examined in patients with clinical stage II and III upper rectal cancer who underwent laparoscopic low anterior resection, including total mesorectal excision. Pathologic resection margins were negative in all patients. Postoperative complications occurred in 22 patients (25.9%), which is similar to incidence rates in previous studies. In multivariate analysis, tumor size (≥4 cm) and tumor category (T4) were independent risk factors for postoperative complications. Precise pretreatment diagnoses with locoregional evaluations are essential for the selection of appropriate patients for laparoscopic rectal resection. Despite quality results from laparoscopic low anterior resection for the treatment of advanced rectal cancer, we must attempt to reduce postoperative complications.
authors.affiliation: *Department of gastroenterological surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases §Department of surgery, National Hospital Organization, Osaka National Hospital **Department of surgery, Osaka General Medical Center, Osaka City ‡Department of gastroenterological surgery, Osaka University Graduate School of Medicine, Suita City ¶Department of surgery, Osaka Rosai Hospital, Sakai City #Department of surgery, Ikeda City Hospital, Ikeda City, Osaka ∥Department of surgery, Nishinomiya Municipal Central Hospital, Nishinomiya City, Hyogo †Department of surgery, surgical oncology and science, Sapporo Medical University, Hokkaido.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yasui
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takemasa
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Taishi
authors.initials: T
authors.lastname: Hata
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Miyake
authors.forename: Junichi
authors.initials: J
authors.lastname: Hasegawa
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Ota
authors.forename: Chu
authors.initials: C
authors.lastname: Matsuda
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Mizushima
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012307:Risk Factors; D013528:Surgical Staplers; D047368:Tumor Burden