Is laparoscopic surgery a contraindication in patients with severe senile kyphosis?

ABSTRACT

BACKGROUND/AIMS: The japanese population have the longest-life expectancy in the world. Accordingly, older patients with colorectal cancer with senile kyphosis caused by aging or osteoporosis also increase. Laparoscopic surgery is minimally-invasive, and performance on severe kyphotic patients may cause difficulty to approach a narrow abdomen. To determine whether laparoscopic surgery is safe and feasible in patients with severe senile kyphosis. METHODS: Laparoscopic operations under general anesthesia were undertaken with the patients in lithotomy position. Intraoperative difficulties were compared with normal laparoscopic approach. RESULTS: Working space was divided by right costal arch during right hemicolectomy for right sided colon cancer. For sigmoid colon cancer, dissection of lymph node and anastomosis were completed with much difficulty because the pelvic space was occupied with small intestine. However, the postoperative course was uneventful despite impaired lung function in all cases. CONCLUSIONS: Severe senile kyphosis is not a contraindication for minimally invasive technique applied to colorectal cancer patients.