Technical difficulty grade score for the laparoscopic approach of rectal cancer (original) (raw)

2008, International Journal of Colorectal Disease

Introduction We aimed to categorize laparoscopic rectal resections according to technical difficulty to standardize learning purposes and stratify results, making future studies more comparable. Materials and methods Fifty patients undergoing a laparoscopic total mesorectal excision were prospectively followed. Four preoperatively known facts (gender, body mass index (BMI), tumor localization, and preoperative radiation therapy) were compared to four operative outcomes (operation time, blood loss, a visual analogue score (VAS) for difficulty rewarded by the surgeon, and oncological radicality of the procedure). Results Operating time for male and female patients was 257 vs. 245 min (P=0.229), blood loss was 300 vs. 300 ml (P=0.309), the VAS was 8 vs. 6 (P<0.001), and radicality was 93% vs. 91% (P=0.806). Operating time was 215, 250, and 305 min for high, mid, and low tumors (Spearman −0.44; P=0.02), respectively. Blood loss was 105, 300, and 600 ml (Spearman −0.38; P=0.01). Lower tumors were rewarded a higher VAS (Spearman −0.57; P<0.001) and