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Clinical impact of single-incision laparoscopic right hemicolectomy with intracorporeal resection for advanced colon cancer: propensity score matching analysis

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Abstract

Background

Laparoscopic right hemicolectomy has become an acceptable treatment for right-sided colon cancer. Most centers use multiport laparoscopic right hemicolectomy extracorporeally (MRHE), whereas single-incision laparoscopic right hemicolectomy intracorporeally (SRHI) remains controversial. The aim of this study was to compare these two techniques using propensity score matching analysis.

Methods

We analyzed the data from 111 patients who underwent laparoscopic right hemicolectomy between December 2015 and December 2016. The propensity score was calculated according to age, gender, body mass index, the American Society of Anesthesiologists score, previous abdominal surgery, and D3 lymph node dissection. Postoperative pain was evaluated using a visual analogue scale (VAS) and postoperative analgesic use was an outcome measure.

Results

The length of skin incision in SRHI was significantly shorter than in MRHE [3 (3.5–6) versus 4 (3–6) cm, respectively; P = 0.007]. The VAS score on day 1 and day 2 after surgery was significantly less in SRHI than in MRHE [30 (10–50) versus 50 (20–69) on day 1, P = 0.037; 10 (0–50) versus 30 (0–70) on day 2, P = 0.029]. Significantly fewer patients required analgesia after SRHI on day 1 and day 2 after surgery [1 (0–3) versus 2 (0–4) on day 1, P = 0.024; 1 (0–2) versus 1 (0–4) on day 2, P = 0.035]. There were no significant differences in operative time, intraoperative blood loss, number of lymph nodes removed, and postoperative course between groups.

Conclusions

SRHI appears to be safe and technically feasible. Moreover, SRHI reduces the length of the skin incision and postoperative pain compared with MRHE.

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References

  1. Lacy AM, Gracia-Valdecasas JC, Delgango S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet 359:2224–2229

    Article  Google Scholar 

  2. Clinical Outcomes of Surgical Therapy Study Group (2007) Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg 246:655–664

    Article  Google Scholar 

  3. The Colon Cancer Laparoscopic or Open Resection Study Group (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomized clinical trial. Lancet Oncol 10:44–52

    Article  Google Scholar 

  4. Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ (2010) Five-year follow-up of the medical research council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 97:1638–1645

    Article  CAS  Google Scholar 

  5. Yamamoto S, Inomata M, Katayama H, Mizusawa J, Etoh T, Konishi F, Sugihara K, Watanabe M, Moriya Y, Kitano S, Japan Clinical Oncology Group Colorectal Cancer Study Group (2014) Short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/ III colon cancer: Japan Clinical Oncology Group Study JCOG 0404. Ann Surg 260:23–30

    Article  Google Scholar 

  6. Huscher CG, Mingoli A, Sgarzini G, Mereu A, Binda B, Brachini G, Trombetta S (2012) Standard laparoscopic versus single-incision laparoscopic colectomy for cancer: early result of a randomized prospective study. Am J Surg 204:115–120

    Article  Google Scholar 

  7. Poon JTC, Cheung CW, Fan JK, Lo OS, Law WL (2012) Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized, controlled trial. Surg Endosc 26:2729–2734

    Article  Google Scholar 

  8. Watanabe J, Ota M, Fujii S, Suwa H, Ishibe A, Endo I (2016) Randomized clinical trial of single-incision versus multiport laparoscopic colectomy. Br J Surg 103:1276–1281

    Article  CAS  Google Scholar 

  9. Hoyuela C, Juvany M, Carvajal F (2017) Single-incision laparoscopy versus standard laparoscopy for colorectal surgery: a systematic review and meta-analysis. Am J Surg 214:127–140

    Article  Google Scholar 

  10. Podda M, Saba A, Porru F, Pisaynu A (2016) Systematic review with meta-analysis of studies comparing single-incision laparoscopic colectomy and multiport laparoscopic colectomy. Surg Endosc 30:4697–4720

    Article  Google Scholar 

  11. Chen WT, Chang SC, Chiang HC, Lo WY, Jeng LB, Wu C, Ke TW (2011) Single-incision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results. Surg Endosc 25:1887–1892

    Article  Google Scholar 

  12. Keshava A, Young CJ, Richardson GL, De-Loyde K (2013) A historical comparison of single incision and conventional multiport laparoscopic right hemicolectomy. Colorectal Dis 15:e618–e622

    Article  CAS  Google Scholar 

  13. Feroci F, Lenzi E, Garzi A, Vannucchi A, Cantafio S, Scatizzi (2013) Intracorporeal versus extracorporeal anastomosis after laparoscopic right hemicolectomy for cancer: a systematic review and meta-analysis. Int J Colorectal Dis 28:1177–1186

    Article  Google Scholar 

  14. Oostendorp SV, Elfrink A, Borstlap W, Schoonmade L, Sietses C, Meijerink J, Tuynman J (2017) Intracorporeal versus extracorporeal anastomosis in right hemicolectomy: a systematic review and meta-analysis. Surg Endosc 31:64–77

    Article  Google Scholar 

  15. Japanese Society for Cancer of the Colon and Rectum (2009) The guidelines for therapy of colorectal cancer. Kanehara Shuppan, Tokyo

    Google Scholar 

  16. Austin PC (2009) Some methods of propensity-score matching had superior performance to others: results of an empirical investigation and Monte Carlo simulations. Biom J 51:171–184

    Article  Google Scholar 

  17. Kim CW, Cho MS, Baek SJ, Hur H, Min BS, Kang J, Baik SH, Lee KY, Kim NK (2015) Oncologic outcomes of single-incision versus conventional laparoscopic anterior resection for sigmoid colon cancer: a propensity-score matching analysis. Ann Surg Oncol 22:924–930

    Article  Google Scholar 

  18. Yun JA, Yun SH, Park YA, Huh JW, Cho YB, Kim HC, Lee WY (2016) Oncologic outcomes of single-incision laparoscopic surgery compared with conventional laparoscopy for colon cancer. Ann Surg 263:973–978

    Article  Google Scholar 

  19. Katsuno G, Fukunaga M, Nagakari K, Yoshikawa S, Azuma D, Kohama S (2016) Short-term and long-term outcomes of single-incision versus multi-incision laparoscopic resection for colorectal cancer: a propensity-score-matched analysis of 214 cases. Surg Endosc 30:1317–1325

    Article  Google Scholar 

  20. Saltzstein SL, Behling CA (2007) Age and time as factors in the left to right shift of the subsite of colorectal adenocarcinoma: a study of 213,383 cases from the California Cancer Registry. J Clin Gastroenterol 41:173–177

    Article  Google Scholar 

  21. Powell AG, Wallance R, McKee RF, Anderson JH, Going JJ, Edwards J, Horgan PG (2012) The relationship between tumor site, clinicopathological characteristics and cancer-specific survival in patients undergoing surgery for colorectal cancer. Colorectal Dis 14:1493–1499

    Article  CAS  Google Scholar 

  22. Benedix F, Kube R, Mayer F, Schmidt U, Gastinger I, Lippert H, Colon/Rectum Carcinomas (Primary Tumor) Study Group (2010) Comparison of 17,641 patients with right- and left-sided colon cancer: differences in epidemiology, perioperative course, histology, and survival. Dis Colon Rectum 53:57–64

    Article  Google Scholar 

  23. Lim DR, Kuk JK, Kim T, Shin EJ (2017) Comparison of oncological outcomes of right-sided colon cancer versus left-sided colon cancer after curative resection: which side is better outcome? Medicine 96:e8241

    Article  Google Scholar 

  24. Leung AL, Cheung HY, Fok BK, Chung CC, Li MK, Tang CN (2013) Prospective randomized trial of hybrid NOTES colectomy versus conventional laparoscopic colectomy for left-sided colonic tumors. World J Surg 37:2678–2682

    Article  Google Scholar 

  25. Grams J, Tong W, Greenstein AJ, Salky B (2010) Comparison of intracorporeal versus extracorporeal anastomosis in laparoscopic-assisted hemicolectomy. Surg Endosc 24:1886–1891

    Article  Google Scholar 

  26. Spanjersberg WR, Reuings J, Keus F, van Laarhoven CJ (2011) Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst Rev 2:CD007635

    Google Scholar 

  27. Takemasa I, Uemura M, Nishimura J, Mizushima T, Yamamoto H, Ikeda M, Sekimoto M, Doki Y, Mori M (2014) Feasibility of single-site laparoscopic colectomy with complete mesocolic excision for colon cancer: a prospective case-control comparison. Surg Endosc 28:1110–1118

    Article  Google Scholar 

  28. Agaba EA, Rainville H, Ikedilo O, Vemulapali P (2014) Incidence of port-site incisional hernia after single-incision laparoscopic surgery. JSLS 18:204–210

    Article  Google Scholar 

  29. Marks JM, Phillips MS, Tacchino R, Roberts K, Onders R, DeNoto G, Gecelter G, Rubach E, Rivas H, Islam A, Soper N, Paraskeva P, Rosemurgy A, Ross S, Shah S (2013) Single-incision laparoscopic cholecystectomy is associated with improved cosmesis scoring at the cost of significantly higher hernia rates: 1-year results of a prospective randomized, multicenter, single-blinded trial of traditional multiport laparoscopic cholecystectomy vs single-incision laparoscopic cholecystectomy. J Am Coll Surg 216:1037–1047

    Article  Google Scholar 

  30. Comajuncosas J, Hermoso J, Gris P, Jimeno J, Orbeal R, Vallverdu H, Lopez Negre JL, Urgelles J, Estalella L, Pares D (2014) Risk factors for umbilical trocar site incisional hernia in laparoscopic cholecystectomy: a prospective 3-year follow-up study. Am J Surg 207:1–6

    Article  Google Scholar 

  31. Buckley FP 3rd, Vassaur HE, Jupiter DC, Crosby JH, Wheeless CJ, Vassaur JL (2016) Influencing factors for port-site hernias after single-incision laparoscopy. Hernia 20:729–733

    Article  Google Scholar 

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Authors and Affiliations

  1. Departments of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan

    Masashi Yamamoto, Mitsuhiro Asakuma, Keitaro Tanaka, Shinsuke Masubuchi, Masatsugu Ishii, Wataru Osumi, Hiroki Hamamoto, Junji Okuda & Kazuhisa Uchiyama

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  1. Masashi Yamamoto
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  2. Mitsuhiro Asakuma
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  3. Keitaro Tanaka
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  4. Shinsuke Masubuchi
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  5. Masatsugu Ishii
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  6. Wataru Osumi
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  7. Hiroki Hamamoto
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  8. Junji Okuda
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  9. Kazuhisa Uchiyama
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Correspondence to Kazuhisa Uchiyama.

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Drs. M. Yamamoto, M. Asakuma, K. Tanaka, S. Masubuchi, M. Ishii, W. Osumi, H. Hamamoto, J. Okuda, and K. Uchiyama have no conflicts of interest or financial ties to disclose.

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Yamamoto, M., Asakuma, M., Tanaka, K. et al. Clinical impact of single-incision laparoscopic right hemicolectomy with intracorporeal resection for advanced colon cancer: propensity score matching analysis. Surg Endosc 33, 3616–3622 (2019). https://doi.org/10.1007/s00464-018-06647-0

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  • DOI: https://doi.org/10.1007/s00464-018-06647-0

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