研究者詳細 - 小倉　淳司

論文 - 小倉　淳司

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直腸癌局所再発・肝転移に対して積極的外科手術により得られた長期生存例に発症した下行結腸stoma部癌の一例

小倉淳司, 上原圭介, 相場利貞, 田中綾, 山東雅紀, 米川佳彦, 大原規彰, 渡辺伸元, 尾上俊介, 宮田一志, 山口淳平, 水野隆史, 深谷昌秀, 伊神剛, 横山幸浩, 江畑智希, 服部憲史, 中山吾郎, 小寺泰弘, 梛野正人

日本消化器病学会東海支部例会プログラム抄録集 131回巻頁： 65 - 65 2019年11月

Cranial-first approach of laparoscopic left colectomy for T4 descending colon cancer invading the Gerota's fascia. 国際誌

Ogura A, Kobayashi R, Kawai S, Takagi K, Kawai K, Maeda T, Aritake T, Nagano N, Kamiya S

Surgical case reports 5 巻 ( 1 ) 頁： 159 - 159 2019年10月

Cranial-first approach for laparoscopic surgery with splenic flexure mobilization. 査読有り

Ogura A, Kobayashi R, Aritake T, Maeda T, Kawai K, Takagi K, Kawai S, Kamiya S

Techniques in Coloproctology 23 巻 ( 7 ) 頁： 693-694 2019年7月

Cranial-first approach for laparoscopic surgery with splenic flexure mobilization.

Ogura A, Kobayashi R, Aritake T, Maeda T, Kawai K, Takagi K, Kawai S, Kamiya S

Techniques in coloproctology 23 巻 ( 7 ) 頁： 693 - 694 2019年7月

Complete Resection without Any Ostomies by Laparoscopic Extended Surgery for Locally Advanced T4 Sigmoid Colon Cancer Invading the Urinary Bladder and Ureter. 査読有り国際誌

Ogura A, Aritake T, Kawai S, Yamamoto S, Takagi K, Kawai K, Maeda T, Kobayashi R, Nagano N, Kamiya S

Case reports in surgery 2019 巻頁： 9598183 - 9598183 2019年

Innovativeな大腸癌診断・治療　直腸癌に対する側方郭清の意義−術前（化学）放射線療法との比較招待有り査読有り

小倉淳司、上原圭介、相場利貞、川井　覚、梛野正人

外科 10 巻頁： 1042 - 1049 2019年

Prognostic implications of MRI-detected lateral nodal disease and extramural vascular invasion in rectal cancer

Schaap, DP; Ogura, A; Nederend, J; Maas, M; Cnossen, JS; Creemers, GJ; van Lijnschoten, I; Nieuwenhuijzen, GAP; Rutten, HJT; Kusters, M

BRITISH JOURNAL OF SURGERY 105 巻 ( 13 ) 頁： 1844 - 1852 2018年12月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：British Journal of Surgery

Background: Lateral nodal disease in rectal cancer remains a subject of debate and is treated differently in the East and the West. The predictive value of lateral lymph node and MRI-detected extramural vascular invasion (mrEMVI) features on oncological outcomes was assessed in this study. Methods: In this retrospective cohort study, data on patients with cT3–4 rectal cancer within 8 cm from the anal verge were considered over a 5-year period (2009–2013). Lateral lymph node size, malignant features and mrEMVI features were evaluated and related to oncological outcomes. Results: In total, 192 patients were studied, of whom 30 (15·6 per cent) underwent short-course radiotherapy and 145 (75·5 per cent) received chemoradiotherapy. A lateral lymph node short-axis size of 10 mm or more was associated with a significantly higher 5-year lateral/presacral local recurrence rate of 37 per cent, compared with 7·7 per cent in nodes smaller than 10 mm (P = 0·041). Enlarged nodes did not result in a higher 5-year rate of distant metastasis (23 per cent versus 27·7 per cent in nodes smaller than 10 mm; P = 0·563). However, mrEMVI positivity was related to more metastatic disease (5-year rate 43 versus 26·3 per cent in the mrEMVI-negative group; P = 0·014), but not with increased lateral/presacral recurrence. mrEMVI occurred in 46·6 per cent of patients with nodes smaller than 10 mm, compared with 29 per cent in patients with nodes of 10 mm or larger (P = 0·267). Conclusion: Although lateral nodal disease is more a local problem, mrEMVI mainly predicts distant recurrence. The results of this study showed an unacceptably high local recurrence rate in patients with a short axis of 10 mm or more, despite neoadjuvant (chemo)radiotherapy.

DOI： 10.1002/bjs.10949

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Endoscopic criteria to evaluate tumor response of rectal cancer to neoadjuvant chemoradiotherapy using magnifying chromoendoscopy. 国際誌

Chino A, Konishi T, Ogura A, Kawachi H, Osumi H, Yoshio T, Kishihara T, Ide D, Saito S, Igarashi M, Akiyoshi T, Ueno M, Fujisaki J

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 44 巻 ( 8 ) 頁： 1247 - 1253 2018年8月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：European Journal of Surgical Oncology

Background and aims: Precise endoscopic assessment of complete response to neoadjuvant chemoradiotherapy before surgery is important for optimizing surgical and non-surgical treatment. We prospectively evaluated the accuracy of the newly proposed endoscopic criteria to identify complete response, using magnifying chromoendoscopy. Methods: New endoscopic criteria were created to define endoscopic complete response, near complete response and incomplete response, using magnifying chromoendoscopy. The criteria contained notable endoscopic findings, including shape of the scar, state of the ulcer, finding of white moss, presence of residual protruded nodules, regenerated pits of the scar, presence of neoplastic pit patterns, and extension of rectal wall. Seventy-nine patients with rectal cancer who received neoadjuvant chemoradiotherapy were prospectively evaluated 1–3 days before resection. Diagnostic accuracy to identify pathological complete response and interobserver agreement among a supervising colonoscopist and two trainees were investigated. Results: Pathological complete response was obtained in 17 patients (21.5%). The diagnostic accuracy of endoscopic complete response was 85%, with a sensitivity of 47%, specificity of 97%, positive predictive value of 80% and negative predictive value of 77%. The kappa-value for interobserver agreement across 3 doctors was 0.57 (standard error, 0.74; 95% confidence interval, 0.39–0.76). Conclusion: The newly proposed endoscopic criteria using magnifying chromoendoscopy achieved excellent diagnostic accuracy to determine good responders to neoadjuvant chemoradiotherapy in rectal cancer, with fair interobserver agreement. The criteria could be clinically useful to select patients for non-surgical management.

DOI： 10.1016/j.ejso.2018.04.013

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Pretreatment Serum Carbohydrate Antigen 19-9 Concentration Is a Predictor of Survival of Patients Who Have Undergone Curative Resection of Stage IV Rectal Cancer. 国際誌

Miki H, Akiyoshi T, Ogura A, Nagasaki T, Konishi T, Fujimoto Y, Nagayama S, Noma H, Saiura A, Fukunaga Y, Ueno M

Digestive surgery 35 巻 ( 5 ) 頁： 389 - 396 2018年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Digestive Surgery

Background: To evaluate whether pretreatment carcinoembryonic antigen and carbohydrate antigen (CA)19-9 are useful predictors of survival in patients with stage IV rectal cancer who have undergone curative resection. Methods: In this retrospective study, data on 73 patients who had undergone curative resection of stage IV rectal cancer were reviewed. Associations between various clinicopathological factors and survival outcomes were analyzed. Results: According to univariate analysis, elevated pretreatment CA19-9 (p = 0.0028), R1 resection (p = 0.0318), and mucinous or poorly differentiated adenocarcinoma (p = 0.0228) were significantly associated with poor overall survival (OS), and lymph node metastasis (p = 0.0211) was significantly associated with poor disease-free survival (DFS). Multivariate analyses showed that elevated pretreatment serum CA19-9 concentration (hazard ratios [HR] 3.33; 95% CI 1.24-9.42; p = 0.0174) was an independent predictor for OS and lymph node metastasis (HR 2.26; 95% CI 1.15-4.82; p = 0.0164) was an independent predictor for DFS. Among 55 patients with recurrences after curative resection, the rate of complete resection of recurrences was significantly higher in patients with normal pretreatment CA19-9 than in those with elevated CA19-9 (p = 0.049). Post-recurrence survival was significantly worse in patients with elevated pretreatment CA19-9 than in those with normal CA19-9 (p = 0.0196). Conclusions: Pretreatment CA19-9 is good predictor of survival after curative resection of stage IV rectal cancer.

DOI： 10.1159/000480247

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Skeletal muscle loss is an independent negative prognostic factor in patients with advanced lower rectal cancer treated with neoadjuvant chemoradiotherapy. 国際誌

Takeda Y, Akiyoshi T, Matsueda K, Fukuoka H, Ogura A, Miki H, Hiyoshi Y, Nagasaki T, Konishi T, Fujimoto Y, Fukunaga Y, Ueno M

PloS one 13 巻 ( 4 ) 頁： e0195406 2018年

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：PLoS ONE

Background The impact of body composition on the short- or long-term outcomes of patients with surgically treated advanced rectal cancer after neoadjuvant chemoradiotherapy remains unclear. This study examined the correlation between low skeletal muscle mass and morbidity and survival in patients with advanced lower rectal cancer. Methods We enrolled 144 clinical stage II/III patients with advanced lower rectal cancer who underwent neoadjuvant chemoradiotherapy followed by curative resection between 2004 and 2011. The cross-sectional skeletal muscle area at the third lumbar vertebra (L3) level was evaluated by computed tomography before chemoradiotherapy, and this was normalized by the square of the height to obtain the skeletal muscle index. Low skeletal muscle mass was defined as the sex-specific lowest quartile of the L3 skeletal muscle index. The association between low skeletal muscle mass and morbidity, relapse-free survival, or overall survival was assessed. Results Low skeletal muscle mass was identified in 37 (25.7%) patients. Age and body mass index were associated with low skeletal muscle mass. By multivariate analysis, we found that low skeletal muscle mass was independently associated with poor overall survival (hazard ratio = 2.93; 95%CI: 1.11–7.71; p = 0.031) and relapse-free survival (hazard ratio = 2.15; 95%CI: 1.06–4.21; p = 0.035), but was not associated with the rate of postoperative complications. Conclusions Low skeletal muscle mass is an independent negative prognostic factor for relapse-free and overall survival in patients with advanced lower rectal cancer treated with neoadjuvant chemoradiotherapy.

DOI： 10.1371/journal.pone.0195406

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頸部嵌頓により急性胆嚢炎を呈した早期胆嚢癌の1例

宇野雅紀, 神谷里明, 川井覚, 高木健司, 前田孝, 小倉淳司, 松浦晃洋

日本臨床外科学会雑誌 79 巻 ( 11 ) 頁： 2346 - 2349 2018年

記述言語：日本語出版者・発行元：日本臨床外科学会

症例は64歳の女性で，心窩部痛と嘔気を主訴に受診した．右季肋部に限局する軽度圧痛があり，CTで胆嚢腫大と胆嚢壁の浮腫状肥厚を認めて，急性胆嚢炎と診断した．胆嚢頸部に腫瘤影を認め，腫瘤の頸部嵌頓が胆嚢炎の原因と考えて，まずは抗菌薬による保存的治療を開始した．しかし，入院3日目に右季肋部痛と炎症所見が増悪したため緊急開腹術を施行した．胆嚢頸部に壁外から腫瘤を触知できず，胆嚢管を総胆管合流部近傍で切離して胆嚢を摘出した．切除標本では胆嚢頸部に径3cmの軟らかい有茎性腫瘍を認めた．肉眼的には腺腫あるいは早期癌が疑われ，追加切除やリンパ節郭清は行わなかった．病理組織検査で早期胆嚢癌と診断され，胆嚢剥離面や胆嚢管断端に癌の進展を認めなかった．胆嚢癌は自覚症状に乏しく，早期癌は胆石症の手術で偶然見つかることも多い．胆嚢頸部への嵌頓により生じた胆嚢炎を契機として発見された早期胆嚢癌はまれであり，報告をする．

DOI： 10.3919/jjsa.79.2346

CiNii Research

The significance of extended lymphadenectomy for colorectal cancer with isolated synchronous extraregional lymph node metastasis. 国際誌

Ogura A, Akiyoshi T, Takatsu Y, Nagata J, Nagasaki T, Konishi T, Fujimoto Y, Nagayama S, Fukunaga Y, Ueno M

Asian journal of surgery 40 巻 ( 4 ) 頁： 254 - 261 2017年7月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Asian Journal of Surgery

Background/Objective The significance of extended lymphadenectomy for colorectal cancer with extraregional lymph node metastasis, such as para-aortic lymph node metastasis, has not been established. The purpose of this study was to evaluate the significance of extended lymphadenectomy for colorectal cancer with synchronous isolated extraregional lymph node metastasis. Methods Between July 2004 and December 2013, 16 patients with synchronous extraregional lymph node metastasis without other organ metastases underwent curative resection and extended lymphadenectomy (R0 group). The clinical characteristics and survival outcomes of the R0 group were compared with those of 12 patients with extraregional lymph node metastasis who underwent palliative surgery (control group). Results In the R0 group, the 5-year cancer-specific survival (CSS) rate was 70.3% and the 5-year relapse-free survival (RFS) rate was 60.5%. The 5-year CSS differed significantly between the R0 and control groups (70.3% vs. 12.5%; p = 0.0003). Univariate analyses revealed that the total numbers of metastatic lymph nodes and metastatic regional lymph nodes present were significantly associated with RFS (p = 0.019 for both). Conclusion Findings from our study suggest that extended lymphadenectomy for colorectal cancer with synchronous isolated extraregional lymph node metastasis might be effective in carefully selected patients.

DOI： 10.1016/j.asjsur.2015.10.003

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Does the depth of mesorectal invasion have prognostic significance in patients with ypT3 lower rectal cancer treated with preoperative chemoradiotherapy? 国際誌

Ogura, A; Akiyoshi, T; Yamamoto, N; Kawachi, H; Ishikawa, Y; Noma, H; Nagino, M; Fukunaga, Y; Ueno, M

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE 32 巻 ( 3 ) 頁： 349 - 356 2017年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：International Journal of Colorectal Disease

Purpose: The prognostic significance of the depth of mesorectal invasion (DMI) in patients with ypT3 rectal cancer who undergo preoperative chemoradiotherapy (CRT) is unclear. The purpose of this study was to evaluate the prognostic significance of DMI in ypT3 rectal cancer. Methods: A total of 168 (y)pT3 patients were evaluated, of whom 93 received preoperative CRT and 75 underwent surgery alone. Patients were subdivided into two groups according to the DMI (T3ab = DMI ≤5 mm and T3cd = DMI >5 mm). Oncologic outcomes were compared between the T3ab and T3cd groups and the ypT3ab and ypT3cd groups. Results: Relapse-free survival was significantly different between the pT3ab and pT3cd groups (74.1 vs 38.5%, P = 0.0192) but not between the ypT3ab and ypT3cd groups (65.9 vs 61.5%, P = 0.513). Multivariate analysis showed that DMI was an independent predictor of recurrence in pT3 patients (hazard ratio [HR] = 2.980, 95% confidence interval [CI] 1.227–7.025; P = 0.0169) and that ypN+ was an independent predictor of recurrence in ypT3 patients (HR = 3.487, 95% CI 1.570–8.827; P = 0.0016). Conclusions: DMI was not a significant predictive factor for recurrence in patients with ypT3 rectal cancer who underwent preoperative CRT, and ypN+ was the only independent predictive factor for recurrence.

DOI： 10.1007/s00384-016-2716-1

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Feasibility of Laparoscopic Total Mesorectal Excision with Extended Lateral Pelvic Lymph Node Dissection for Advanced Lower Rectal Cancer after Preoperative Chemoradiotherapy. 国際誌

Ogura A, Akiyoshi T, Nagasaki T, Konishi T, Fujimoto Y, Nagayama S, Fukunaga Y, Ueno M, Kuroyanagi H

World journal of surgery 41 巻 ( 3 ) 頁： 868 - 875 2017年3月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：World Journal of Surgery

Background: The feasibility of additional lateral pelvic lymph node dissection (LPLND) compared with total mesorectal excision (TME) alone in patients treated with preoperative chemoradiotherapy (CRT) is controversial, especially in laparoscopic surgery. This study was performed to evaluate the feasibility of adding laparoscopic LPLND to TME in patients with advanced lower rectal cancer and swollen LPLNs treated with preoperative CRT. Methods: We reviewed 327 patients with lower rectal cancer without distant metastasis who underwent preoperative CRT followed by laparoscopic TME. Laparoscopic LPLND was added in patients with swollen LPLNs before CRT. Outcomes were compared between patients with (n = 107) and without (n = 220) LPLND. Results: LPLN metastasis was found in 26 patients (24.3 %) in the LPLND group. The operation time was significantly longer, and total blood loss was significantly greater in the LPLND than TME group (461 vs. 298 min and 115 vs. 30 mL, respectively; P < 0.0001). The major complication rate was similar in the LPLND and TME groups (9.3 vs. 5.5 %, respectively; P = 0.188), and there were no conversions to open surgery. The LPLND and TME groups also showed a similar 3-year relapse-free survival rate (84.7 vs. 82.0 %, respectively; P = 0.536) and local recurrence rate (3.2 vs. 5.2 %, respectively; P = 0.569) despite significantly more patients with pathological lymph node metastasis in the LPLND than TME group (37.4 vs. 22.3 %, respectively; P < 0.0001). Conclusions: Additional laparoscopic LPLND is feasible in patients with advanced lower rectal cancer and clinically swollen LPLNs treated with preoperative CRT, with no significant increase in major complications compared with TME alone.

DOI： 10.1007/s00268-016-3762-0

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腹腔鏡下回盲部切除を施行した虫垂子宮内膜症による虫垂重積の1例

武田泰裕, 長嵜寿矢, 福岡宏倫, 小倉淳司, 三城弥範, 日吉幸晴, 秋吉高志, 小西毅, 藤本佳也, 長山聡, 福長洋介, 上野雅資

日本大腸肛門病学会雑誌 70 巻 ( 7 ) 頁： 463 - 468 2017年

記述言語：日本語出版者・発行元：日本大腸肛門病学会

患者は45歳，女性，主訴は下腹部痛と下血．下部内視鏡検査で虫垂開口部に30mm径で弾性硬な粘膜下腫瘍様隆起を指摘．腹部造影CTでも同部位に造影効果を伴う充実性腫瘤を認め，原発性虫垂癌および粘膜下腫瘍を疑い，周囲リンパ節腫大もあったため診断および治療目的に腹腔鏡下回盲部切除術を施行した．切除検体の肉眼所見では虫垂体部が盲腸内腔に向かって重積様に突出し，虫垂は著明に短縮していた．病理組織学的検査で粘膜下層から固有筋層にかけて強い線維化と子宮内膜組織を散在性に認め，虫垂子宮内膜症による完全型の虫垂重積症と診断した．虫垂子宮内膜症とそれによる虫垂重積症は非常にまれであり，腸管子宮内膜症は粘膜下腫瘍様の形態をとるため術前診断は困難とされる．今回，原発性虫垂腫瘍との鑑別に苦慮し，腹腔鏡下回盲部切除術を施行した虫垂子宮内膜症による虫垂重積の1例を経験したので文献的考察を加えて報告する．

DOI： 10.3862/jcoloproctology.70.463

CiNii Research

Pagetoid spreadを伴う肛門管腺癌に対して術前全身化学療法と化学放射線療法を行いpCRが得られた1例

福岡宏倫, 長嵜寿矢, 三城弥範, 日吉幸晴, 小倉淳司, 秋吉高志, 藤本佳也, 長山聡, 福長洋介, 高松学, 上野雅資

日本大腸肛門病学会雑誌 70 巻 ( 2 ) 頁： 81 - 87 2017年

記述言語：日本語出版者・発行元：日本大腸肛門病学会

症例は50歳女性，主訴は右鼠径部腫瘤．肛門管から下部直腸にかかる隆起性病変と肛門周囲皮膚に全周性の硬結・発赤を認めた．生検で肛門管内腫瘤から高分化腺癌，肛門周囲皮膚発赤部から上皮内に浸潤する癌細胞を認めた．精査にて右側方/鼠径リンパ節転移，肛門周囲皮膚へのpagetoid spreadを伴う肛門管腺癌と診断した．術前全身化学療法と術前化学放射線療法の後，腹腔鏡下直腸切断術，右側方/鼠径リンパ節郭清，会陰創皮弁形成術を施行．術後病理所見で癌細胞は認めず，pathological complete responseだった．Pagetoid spreadを伴う肛門管腺癌はまれであり確立した治療法はなく，予後不良である．本症例は術前治療が非常に有効であり，術前病期によっては前治療を含めた集学的治療も考慮するべきである．

DOI： 10.3862/jcoloproctology.70.81

CiNii Research

Patient-centered outcomes to decide treatment strategy for patients with low rectal cancer. 国際誌

Honda M, Akiyoshi T, Noma H, Ogura A, Nagasaki T, Konishi T, Fujimoto Y, Nagayama S, Fukunaga Y, Ueno M

Journal of surgical oncology 114 巻 ( 5 ) 頁： 630 - 636 2016年10月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Journal of Surgical Oncology

Background: For patients with low-lying rectal cancer, the feasibility of anus-preserving surgery in combination with neoadjuvant chemoradiotherapy (NACRT) has been not well established from the perspective of patient-centered outcomes. Methods: We investigated 278 patients with low-lying rectal adenocarcinoma from 2005 to 2012. We compared their symptoms and QOL scores of patients who underwent anus-preserving surgery with (n = 88) and without (n = 143) NACRT according to the Wexner scale, EORTC QLQ C-30, CR29, and the modified fecal incontinence quality life scale (mFIQL). Furthermore, to assess the rationale for intersphincteric resection (ISR) with NACRT, we also compared QOL of patients who underwent ISR with NACRT (n = 31) and abdominoperineal resection (APR, n = 47). Results: The adjusted mean differences of the Wexner score estimates of the patients who underwent ISR and very low anterior resection (VLAR) with or without NACRT were 5.29 (P = 0.004) and 2.67 (P = 0.009), respectively. No significant difference was observed in the QOL scores of two treatment groups. Furthermore, there were no significant differences in the QOL or function scores of patients who underwent ISR with NACRT and APR. Conclusion: The incontinence was significantly worse in patients who receive NACRT. However, there were no significant differences in their QOL or function scores. J. Surg. Oncol. 2016;114:630–636. © 2016 Wiley Periodicals, Inc.

DOI： 10.1002/jso.24376

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Safety of Laparoscopic Pelvic Exenteration with Urinary Diversion for Colorectal Malignancies. 査読有り

Ogura A, Akiyoshi T, Konishi T, Fujimoto Y, Nagayama S, Fukunaga Y, Ueno M.

World Journal of Surgery 2016 巻 ( 40 ) 頁： 1236-1243 2016年5月

Safety of Laparoscopic Pelvic Exenteration with Urinary Diversion for Colorectal Malignancies.

4. Ogura A, Akiyoshi T, Konishi T, Fujimoto Y, Nagayama S, Fukunaga Y, Ueno M.

World Journal of Surgery 40 巻 ( 5 ) 頁： 1236-1243 2016年5月

Safety of Laparoscopic Pelvic Exenteration with Urinary Diversion for Colorectal Malignancies. 国際誌

Ogura A, Akiyoshi T, Konishi T, Fujimoto Y, Nagayama S, Fukunaga Y, Ueno M

World journal of surgery 40 巻 ( 5 ) 頁： 1236 - 43 2016年5月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：World Journal of Surgery

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). Conclusion: 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.

DOI： 10.1007/s00268-015-3364-2

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