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Laparoscopic Surgery for Colon Cancer in Japan. JSCCR Guidelines. (Japanese Society for Cancer of the Colon and Rectum). Laparoscopic surgery . Criteria: stage 0 /stage I colon/ rectsigmoid cancer. Stage II/stage III : depend on experience of surgeons. JSCCR Guidelines.

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jsccr guidelines
JSCCR Guidelines

(Japanese Society for Cancer of the Colon and Rectum)

Laparoscopic surgery

Criteria: stage 0 /stage I colon/rectsigmoid cancer

Stage II/stage III: depend on experience of surgeons

jsccr guidelines1
JSCCR Guidelines

(Japanese Society for Cancer of the Colon and Rectum)

Laparoscopic surgery

Scope of lymph node dissection

is decided by clinical stage

Criteria: stage 0 /stage I colon/rectsigmoid cancer

Stage II/stage III: depend on experience of surgeons

D2 dissection

D3 dissection

is lap surgery safe for t4 tumor
Is Lap Surgery Safe for T4 Tumor?

CO2 gas flows

may increase cancer dissemination

in the abdominal cavity.

depth of invasion and circumferential occupation1
Depth of Invasion and Circumferential Occupation

217 colon cancers

T4b

T4a

Lap colectomy is indicated for the tumors

with less than ½ of circumferential occupation

T3

T2

depth of invasion and circumferential occupation2
Depth of Invasion and Circumferential Occupation

Prospective Study

≦ pT3

pT4

≦ 1/2

41

34

7

1/2 <

102

60

42

49

94

Specificity: 86%

17%

Sensitivity: 36%

l ap surgery for crc has been increasing
Lap. Surgery for CRChas been increasing

14,000

T0/T1

12,000

lap.

16639

10,000

T3/T4

open

49354

8,000

Surgery for CRC

in 2009

6,000

4,000

2,000

j cog0404
JCOG0404

1057 cases (Mar. 2009 )

1000

T3/T4 Colon Cancer

900

Randomization

800

700

Open Colectomy

Laparoscopic Colectomy

600

Primary endpoint: OS

500

400

300

200

100

0

05/

06/

07/

08/

6

09/3

6

6

1

1

1

6

1

laparoscopic surgery for right colon cancer
Laparoscopic Surgery for Right Colon Cancer

4

Display

2

3

5mm

10mm

Operator

Asistant

5

1

10mm

5mm

Scopist

laparoscopic surgery for sigmoid colon cancer
Laparoscopic Surgery for Sigmoid Colon Cancer

Scopist

3

5mm

5mm

4

1

Operator

Asistant

2

10mm

10mm

Display

5

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