caa a22 4500 445334371 CHVBK 20180317142748.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1245/s10434-010-1530-1 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1530-1 Outcome of Laparoscopic Resection for Colorectal Cancer in Patients with High Operative Risk [Elektronische Daten] [Jensen Poon, Wai-Lun Law, Lorraine Chow, Joe Fan, Siu-Hung Lo] Background: There is general concern that high-risk patients are more susceptible to the adverse effect of pneumoperitoneum and they are often denied laparoscopic surgery. This study investigated the impact of laparoscopic colorectal cancer resection for patients with high operative risk, which was defined as American Society of Anesthesiologist classes 3 and 4. Methods: Three hundred thirty-five consecutive high-risk patients who had colorectal cancer resection by open or laparoscopic surgery were included. The patient and tumor characteristics and operative outcomes were recorded prospectively, and comparison was made between the two groups. Results: Compared to open surgery, patients with laparoscopic resection had a shorter hospital stay (8 [6-12] vs. 6 [4-9] days; P<0.001), less blood loss (200 [100-400] vs. 140 [80-250] mL; P=0.006), reduced cardiac complication rate (13.2% vs. 3.7%; P=0.006), overall operative complication rate (36.6% vs. 21.3%; P=0.006), and a trend toward a lower mortality rate (4.4% vs. 0.9%; P=0.083). There was no difference in 3-year overall and disease-free survival between two groups. Operative blood loss (P=0.035; odds ratio=2.69; 95% confidence interval, 1.00-6.78) and open surgery (P=0.007; odds ratio=2.31; 95% confidence interval, 1.26-4.23) were independent factors for occurrence of complication. Conclusions: Laparoscopic colorectal cancer resection is associated with more favorable short-term results and should be recommended as the preferred treatment option for high-risk patients. Society of Surgical Oncology, 2011 Poon Jensen Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut Law Wai-Lun Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut Chow Lorraine Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut Fan Joe Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut Lo Siu-Hung Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 1884-1890 1068-9265 18:7<1884 2011 18 10434 https://doi.org/10.1245/s10434-010-1530-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1530-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Poon Jensen Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut NATIONALLICENCE 700 1- Law Wai-Lun Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut NATIONALLICENCE 700 1- Chow Lorraine Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut NATIONALLICENCE 700 1- Fan Joe Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut NATIONALLICENCE 700 1- Lo Siu-Hung Division of Colorectal Surgery, Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/7(2011-07-01), 1884-1890 1068-9265 18:7<1884 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer