Dr Veenhof and colleagues from the Netherlands categorized laparoscopic rectal resections according to technical difficulty.
The team aimed to standardize learning purposes and stratify results, making future studies more comparable.
The research team prospectively followed 50 patients undergoing a laparoscopic total mesorectal excision.
|Operating time for irradiated patients was 277 min|
The team evaluated 4 preoperatively known facts, including gender, body mass index, tumor localization, and preoperative radiation therapy.
The researchers compared these to 4 operative outcomes.
The operative outcomes included operation time, blood loss, a visual analogue score for difficulty rewarded by the surgeon, and oncological radicality of the procedure.
The researchers found that operating time for male and female patients was 257 vs 245 min, and blood loss was 300 vs 300 ml, respectively.
For male and female patients, the team noted that the visual analogue score was 8 vs 6, and radicality was 93% vs 91%, respectively.
Operating time was 215, 250, and 305 min for high, mid, and low tumors, respectively.
The research team found that blood loss was 105, 300, and 600 ml for high, mid, and low tumours, respectively.
Lower tumors were rewarded a higher visual analogue score, and were less often radically resected.
Operating time for irradiated and nonirradiated patients was 277 vs 225 min, and blood loss was 500 vs 150 ml.
The researchers observed that for irradiated and nonirradiated patients, the visual analogue score was 7 vs 5, and radicality was 79% vs. 100%, respectively.
Operating time was 240 min for a body mass index 25 to 30, and 253 min for a body mass index over 30.
The team noted that blood loss was 150 ml for a body mass index of 25 to 30, and 500 ml for a body mass index over 30.
The team found that a higher body mass index was rewarded a higher visual analogue score.
Body mass index had no correlation to radicality of the procedure.
The team noted an association between technical difficulty score and operation time, blood loss, visual analogue score, and radicality of surgery.
Dr Veenhof's team concluded, "Laparoscopic surgery in male, irradiated, and obese patients with lower tumors seemed more difficult."
"A categorization according to technical difficulty, to preoperatively predict difficulty of the procedure, was found feasible."