International Journal of Colorectal Disease

, Volume 31, Issue 1, pp 115–122 | Cite as

Short-term outcomes following reduced-port, single-port, and multi-port laparoscopic surgery for colon cancer: tailored laparoscopic approaches based on tumor size and nodal status

  • Hyeon Yu
  • Jin Yong ShinEmail author
Original Article



Surgeons have recently developed more minimally invasive surgical procedures to reduce surgical stress and improve cosmesis. Although single-port laparoscopic colectomy (SPLC) has potential benefits over multi-port laparoscopic colectomy (MPLC), there are concerns about the increased technical difficulties associated with SPLC. Therefore, we attempted reduced-port laparoscopic colectomy (RPLC). The purpose of this study was to evaluate the difference in perioperative outcome following tailored laparoscopic approaches for colon cancer on the basis of tumor characteristics.


The prospectively collected data of 170 patients who underwent only minimally invasive colectomy for colon cancer from July 2010 to June 2013 were reviewed. The MPLC, SPLC, and RPLC groups comprised 92 (54.1 %), 40 (23.5 %), and 38 (22.4 %) patients, respectively.


The number of harvested lymph nodes was significantly higher in the RPLC group than in the MPLC and SPLC groups (29.9 ± 21.5, 21.9 ± 12.1, and 24.2 ± 13.8, respectively; p = 0.027). The mean operating time was significantly different among the MPLC, SPLC, and RPLC groups (243.5 ± 59.0, 207.2 ± 49.6, and 216.2 ± 53.7 min, respectively; p = 0.001). The time to first flatus was also significantly different among the MPLC, SPLC, and RPLC groups (3.1 ± 1.2, 3.6 ± 1.3, and 3.4 ± 1.1 days, respectively; p = 0.039). No significant differences in the other short-term surgical outcomes were observed among the three groups.


SPLC and RPLC according to tailored laparoscopic approaches for colon cancer appear to be beneficial in terms of operative time and lymph node retrieval, and may be considered as surgical options in laparoscopic colectomy for colon cancer patients with favorable tumor characteristics.


Colon cancer Laparoscopic surgery Colectomy Outcomes 



The statistical analysis was supported by the Clinical Trial Center of Inje University Busan Paik.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This study was approved by the ethics committee of Inje University Haeundae Paik Hospital (institutional review board code: 129792-2014-123).

Informed consent

All patients provided written informed consent before undergoing the surgical procedure.


  1. 1.
    Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1(3):144–150PubMedGoogle Scholar
  2. 2.
    Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359(9325):2224–2229PubMedCrossRefGoogle Scholar
  3. 3.
    Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM, UK MRC CLASICC Trial Group (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25(21):3061–3068PubMedCrossRefGoogle Scholar
  4. 4.
    Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350(20):2050–2059CrossRefGoogle Scholar
  5. 5.
    Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H, 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(4):655–662PubMedCrossRefGoogle Scholar
  6. 6.
    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(11):1638–1645PubMedCrossRefGoogle Scholar
  7. 7.
    Hasegawa F, Kawamura YJ, Sasaki J, Tsujinaka S, Konishi F (2013) Oncological 3-port laparoscopic colectomy by 1 surgeon and 1 camera operator: a preliminary report. Surg Laparosc Endosc Percutan Tech 23(2):176–179PubMedCrossRefGoogle Scholar
  8. 8.
    Park JM, Suh SW, Kwak JM, Kim J, Kim SH (2011) Three-port laparoscopy-assisted colectomy for colorectal cancer using external traction with suspension suture. Surg Laparosc Endosc Percutan Tech 21(5):e249–e252PubMedCrossRefGoogle Scholar
  9. 9.
    Bresadola F, Pasqualucci A, Donini A, Chiarandini P, Anania G, Terrosu G, Sistu MA, Pasetto A (1999) Elective transumbilical compared with standard laparoscopic cholecystectomy. Eur J Surg 165(1):29–34PubMedCrossRefGoogle Scholar
  10. 10.
    Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 9(4):361–364PubMedCrossRefGoogle Scholar
  11. 11.
    Rispoli G, Armellino MF, Esposito C (2002) One-trocar appendectomy. Surg Endosc 16(5):833–835PubMedCrossRefGoogle Scholar
  12. 12.
    Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR, Moore C, Gill IS (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71(1):3–6PubMedCrossRefGoogle Scholar
  13. 13.
    Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Color Dis 10(8):823–826CrossRefGoogle Scholar
  14. 14.
    Choi SI, Lee KY, Park SJ, Lee SH (2010) Single port laparoscopic right hemicolectomy with D3 dissection for advanced colon cancer. World J Gastroenterol 16(2):275–278PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Poon JT, 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(10):2729–2734PubMedCrossRefGoogle Scholar
  16. 16.
    Lim SW, Kim HJ, Kim CH, Huh JW, Kim YJ, Kim HR (2013) Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer. Tech Coloproctol 17(2):193–199PubMedCrossRefGoogle Scholar
  17. 17.
    Choi EK, Yoo IR, Park HL, Choi HS, Han EJ, Kim SH, Chung SK, Joo Hyun O (2012) Value of surveillance (18)F-FDG PET/CT in colorectal cancer: comparison with conventional imaging studies. Nucl Med Mol Imaging 46(3):189–195PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Kim SJ, Choi BJ, Lee SC (2014) Overview of single-port laparoscopic surgery for colorectal cancers: past, present, and the future. World J Gastroenterol 20(4):997–1004PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Ishii Y, Hasegawa H, Endo T, Ochiai H, Okabayashi K, Kitagawa Y (2013) Reduced-port laparoscopic surgery for rectal cancer: feasibility based on our early experience. Asian J Endosc Surg 6(3):249–252PubMedCrossRefGoogle Scholar
  21. 21.
    Hirano Y, Hattori M, Douden K, Shimizu S, Sato Y, Maeda K, Hashizume Y (2012) Single-incision plus one port laparoscopic anterior resection for rectal cancer as a reduced port surgery. Scand J Surg 101(4):283–286PubMedCrossRefGoogle Scholar
  22. 22.
    Costedio MM, Aytac E, Gorgun E, Kiran RP, Remzi FH (2012) Reduced port versus conventional laparoscopic total proctocolectomy and ileal J pouch-anal anastomosis. Surg Endosc 26(12):3495–3499PubMedCrossRefGoogle Scholar
  23. 23.
    Champagne BJ, Lee EC, Leblanc F, Stein SL, Delaney CP (2011) Single-incision vs straight laparoscopic segmental colectomy: a case-controlled study. Dis Colon Rectum 54(2):183–186PubMedCrossRefGoogle Scholar
  24. 24.
    Kurmann A, Vorburger SA, Candinas D, Beldi G (2011) Operation time and body mass index are significant risk factors for surgical site infection in laparoscopic sigmoid resection: a multicenter study. Surg Endosc 25(11):3531–3534PubMedCrossRefGoogle Scholar
  25. 25.
    Hübner M, Diana M, Zanetti G, Eisenring MC, Demartines N, Troillet N (2011) Surgical site infections in colon surgery: the patient, the procedure, the hospital, and the surgeon. Arch Surg 146(11):1240–1245PubMedCrossRefGoogle Scholar
  26. 26.
    Kim SJ, Ryu GO, Choi BJ, Kim JG, Lee KJ, Lee SC, Oh ST (2011) The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer. Ann Surg 254(6):933–940PubMedCrossRefGoogle Scholar
  27. 27.
    Hasegawa H, Kabeshima Y, Watanabe M, Yamamoto S, Kitajima M (2003) Randomized controlled trial of laparoscopic versus open colectomy for advanced colorectal cancer. Surg Endosc 17(4):636–640PubMedCrossRefGoogle Scholar
  28. 28.
    Lim SB, Choi HS, Jeong SY, Park JG (2008) Feasibility of laparoscopic techniques as the surgical approach of choice for primary colorectal cancer: an analysis of 570 consecutive cases. Surg Endosc 22(12):2588–2595PubMedCrossRefGoogle Scholar
  29. 29.
    Braga M, Vignali A, Gianotti L, Zuliani W, Radaelli G, Gruarin P, Dellabona P, Di Carlo V (2002) Laparoscopic versus open colorectal surgery: a randomized trial on short-term outcome. Ann Surg 236(6):759–766, discussion 767 PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Le Voyer TE, Sigurdson ER, Hanlon AL, Mayer RJ, Macdonald JS, Catalano PJ, Haller DG (2003) Colon cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089. J Clin Oncol 21(15):2912–2919PubMedCrossRefGoogle Scholar
  31. 31.
    Park SJ, Lee KY, Kang BM, Choi SI, Lee SH (2013) Initial experience of single-port laparoscopic surgery for sigmoid colon cancer. World J Surg 37(3):652–656PubMedCrossRefGoogle Scholar
  32. 32.
    Rosati CM, Boni L, Dionigi G, Cassinotti E, Giavarini L, David G, Rausei S, Rovera F, Dionigi R (2013) Single port versus standard laparoscopic right colectomies: results of a case-control retrospective study on one hundred patients. Int J Surg 11(Suppl 1):S50–S53PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of Surgery, Inje University College of MedicineInje University Haeundae Paik HospitalBusanRepublic of Korea

Personalised recommendations