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Laparoscopic Colorectal Cancer Surgery for Patients With Severe Chronic Heart Failure
Shoichiro Nakajo1, Mamoru Uemura2, Yuki Sekido1
1Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
Background/Aim:
Laparoscopic surgery with pneumoperitoneum is not usually recommended for patients with heart failure due to the potential risks associated with cardiopulmonary stress. Few studies, however, have directly examined whether a laparoscopic approach can be used safely in patients with severe chronic heart failure.
Patients And Methods:
We retrospectively evaluated the safety and feasibility of laparoscopic colorectal cancer surgery in 13 patients with severe chronic heart failure, defined as left ventricular ejection fraction <40% and/or brain natriuretic peptide >100 pg/ml (NT-proBNP >400 pg/ml). Intraoperative hemodynamics, including systolic blood pressure, diastolic blood pressure, mean blood pressure, and heart rate, were carefully monitored.
Results:
The median left ventricular ejection fraction value was 35% (18-62%), and the median brain natriuretic peptide value was 171.7 pg/ml (109.5-961.4 pg/ml). The time-series mean ratio of the patients' blood pressure and heart rate during surgery indicated that soon after the induction of general anesthesia, mean blood pressure was significantly decreased (p<0.05) from baseline. In all 13 cases, laparoscopic surgery was performed successfully, with no significant complications.
Conclusion:
The present study showed that laparoscopic surgery for colorectal cancer can be performed safely in patients with severe chronic heart failure.
