Abstract
Background
Reduced-port laparoscopic surgery is the latest innovation in minimally invasive surgery. We performed single-incision plus one additional port laparoscopy-assisted anterior resection (SILS + 1-AR) starting in August 2010. This study aimed at evaluating the feasibility of SILS + 1-AR and comparing it with that of conventional laparoscopy-assisted anterior resection (C-AR).
Methods
Patients with preoperative clinical stage 0 to stage III rectal cancer were included. Demographic, intraoperative, and pathological examination data, as well as short-term outcome data, of 20 patients who underwent SILS + 1-AR were retrospectively compared with that of 20 patients who underwent C-AR. Invasiveness of the two procedures was also evaluated through a vital signs diary and hematological examination on postoperative days (POD) 1, 3, and 7.
Results
Operating time, mean estimated blood loss, the number of lymph nodes dissected, the number of lymph node metastases, and the mean distal resection margin length were not significantly different. However, postoperative neutrophil counts in the SILS + 1-AR group were lower than those in the C-AR group (P = 0.085). A significant difference in body temperature was observed in the SILS + 1-AR group on POD 1 (P = 0.028). No significant differences were observed in perioperative and overall morbidity between the two groups. Conversion to open surgery was required in 2 (10 %) of the 20 patients in the SILS + 1-AR group. The mean postoperative length of stay and recurrence rates were similar in the two groups.
Conclusion
SILS + 1-AR for rectal cancer is similar to C-AR in safety, feasibility, and provision of oncological radicality.
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References
Fleshman J, Sargent DJ, Green E et al (2007) Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg 246:655–662
Jayne DG, Guillou PJ, Thorpe H et al (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25:3061–3068
van der Pas MH, Haglind E, Cuesta MA et al (2013) Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol 14:210–218
Ahmed K, Wang TT, Patel VM et al (2011) The role of single-incision laparoscopic surgery in abdominal and pelvic surgery: a systematic review. Surg Endosc 25:378–396
Gandhi DP, Ragupathi M, Patel CB et al (2010) Single-incision versus hand-assisted laparoscopic colectomy: a case-matched series. J Gastrointest Surg 14:1875–1880
Chen WT, Chang SC, Chiang HC et al (2011) Single-incision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results. Surg Endosc 25:1887–1892
Curcillo PG (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97:1884
Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97:1881–1883
Lim SW, Kim HJ, Kim CH et al (2012) Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer. Tech Coloproctol 17:193–199
Kawamura H, Tanioka T, Funakoshi T et al (2011) Dual-ports laparoscopy-assisted distal gastrectomy compared with conventional laparoscopy-assisted distal gastrectomy. Surg Laparosc Endosc Percutan Tech 21:429–433
Hirano Y, Hattori M, Douden K et al (2012) Single-incision plus one port laparoscopic anterior resection for rectal cancer as a reduced port surgery. Scand J Surg 101:283–286
Watanabe T, Itabashi M, Shimada Y et al (2012) Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2010 for the treatment of colorectal cancer. Int J Clin Oncol 17:1–29
Kapiteijn E, Marijnen CA, Nagtegaal ID et al (2001) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345:638–646
Chambers WM, Bicsak M, Lamparelli M et al (2011) Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis 13:393–398
Osborne AJ, Lim J, Gash KJ et al (2013) Comparison of single-incision laparoscopic high anterior resection with standard laparoscopic high anterior resection. Colorectal Dis 15:329–333
Lim SW, Kim HJ, Kim CH et al (2013) Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer. Tech Coloproctol 17:193–199
Adair J, Gromski MA, Lim RB et al (2010) Single-incision laparoscopic right colectomy: experience with 17 consecutive cases and comparison with multiport laparoscopic right colectomy. Dis Colon Rectum 53:1549–1554
Egi H, Hattori M, Hinoi T et al (2012) Single-port laparoscopic colectomy versus conventional laparoscopic colectomy for colon cancer: a comparison of surgical results. World J Surg Oncol 10:61
Peeters KC, Marijnen CA, Nagtegaal ID et al (2007) The TME trial after a median follow-up of 6 years: increased local control but no survival benefit in irradiated patients with resectable rectal carcinoma. Ann Surg 246:693–701
Sauer R, Liersch T, Merkel S et al (2012) Preoperative versus postoperative chemoradiotherapy for locally advanced rectal cancer: results of the German CAO/ARO/AIO-94 randomized phase III trial after a median follow-up of 11 years. J Clin Oncol 30:1926–1933
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Kawamata, F., Homma, S., Minagawa, N. et al. Comparison of Single-Incision Plus One Additional Port Laparoscopy-assisted Anterior Resection with Conventional Laparoscopy-assisted Anterior Resection for Rectal Cancer. World J Surg 38, 2716–2723 (2014). https://doi.org/10.1007/s00268-014-2642-8
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DOI: https://doi.org/10.1007/s00268-014-2642-8