Analysis of the present situation in laparoscopic lymph node dissection for colorectal cancer in hiroshima prefecture

Abstract

Aim : In this paper, we aimed at to clarify factors affecting advantages and disadvantages in terms of acquiring curability and safety in laparoscopic lymph node dissection (LSD) for colorectal cancer. Methods : We conducted a questionnaire survey for 26 institutions in Hiroshima prefecture to make advantages and disadvantages clear in performing LSD. According to the number of their experienced cases of LSD, we classified these institutions into 3 groups, namely inexperienced institution, intermediately experienced institution, and experienced institution groups. Results : These were 8 experienced institutions, 7 intermediately experienced institutions, and 11 inexperienced institutions. In all groups, advantages of LSD were mainly good visual information representing “magnificent view” or “view that can not be acquired in open surgery”. In inexperienced institutions, the good visual information was disturbed by the inability to get good surgical fields. The inability might be caused by operator's unskilled directions, assistant's ineffective retractions of organs, or scopist's poor techniques. Conclusions : In order to acquire curability and safety in LSD for colorectal cancer, it is necessary for all operative lineups, namely operator, assistant, and scopist, to build up good visual informations in surgical fields.