Intraabdominal pressure of Laparoscopic Assisted Colectomy may accelerate to induce metastasis postoperatively

The indication of Laparoscopic Assisted Colectomy (LAC) for colonic cancer has been extending. However,it is not uncertain I,AC is benefical to patien ts as compared to OCR (open colon resection). We asked whether prognosis of patients might be affected by LAG, and investigated the relationship betwe en intraabdominal pressure of LAC and postoperative liver metastasis in the cases of positive intravenous invasion. We have examined 31 patients of si gmoidal carcinoma with intravenous invasion (LCR: OCR = 18 : 13). The frequ ence of liver metastasis and the liver metastasis-free interval for the LCR and OCR groups were 17 and 15 %, 175.3+/-216 and 255+/-106 days, respectiv ely. It seems that liver metastasis were induced earlier in LCR as compare with OCR even if it was not significant. It might be important to use low g rade of intraabdominal pressure, e.g. at least < 11mg, to prevent such nega tive effects of LAG.