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Feasibility of Single-Port Laparoscopic Surgery for Sigmoid Colon and Rectal Cancers and Preoperative Assessment of Operative Difficulty

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Purpose

Single-port laparoscopic surgery is more difficult for sigmoid colon and rectal cancers than for right-sided colon cancer. We sought to analyze the feasibility of this procedure for sigmoid colon and rectal cancers and to estimate its difficulty.

Methods

We analyzed prospectively collected data from 63 consecutive patients with sigmoid colon or rectal cancers who underwent single-port laparoscopic surgery at our institution from June 2009 to December 2011. Patient and tumor characteristics, including patients’ pelvic anatomy which was assessed on CT scan imaging, were evaluated to elucidate what factors would affect the difficulty of the procedure and the necessity of using an additional trocar.

Results

Overall, the median operative duration was 190 min and blood loss was 20 ml, with no postoperative complications. The median number of lymph nodes harvested was 17 and the distal margin was 58 mm. The tumor was located significantly closer to the anus in cases in which an additional trocar was required in the right lower quadrant (9.5 vs 18 cm, p < 0.0001). Procedural difficulty was significantly increased in cases in which the sacral promontory protruded ventrally (odds ratio 0.779 [95 % confidence interval 0.613 to 0.945], p = 0.0236).

Conclusions

Depending on tumor location and sacral promontory shape, the introduction of an additional trocar might render single-port laparoscopic surgery feasible for sigmoid colon and rectal cancer resection.

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The authors declare that they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Atsushi Hamabe, Ichiro Takemasa, Mamoru Uemura, Junichi Nishimura, Tsunekazu Mizushima, Masataka Ikeda, Hirofumi Yamamoto, Mitsugu Sekimoto, Yuichiro Doki & Masaki Mori

Authors
  1. Atsushi Hamabe
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  2. Ichiro Takemasa
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  3. Mamoru Uemura
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  4. Junichi Nishimura
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  5. Tsunekazu Mizushima
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  6. Masataka Ikeda
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  7. Hirofumi Yamamoto
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  8. Mitsugu Sekimoto
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  9. Yuichiro Doki
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  10. Masaki Mori
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Correspondence to Ichiro Takemasa.

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Hamabe, A., Takemasa, I., Uemura, M. et al. Feasibility of Single-Port Laparoscopic Surgery for Sigmoid Colon and Rectal Cancers and Preoperative Assessment of Operative Difficulty. J Gastrointest Surg 18, 977–985 (2014). https://doi.org/10.1007/s11605-014-2463-y

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  • DOI: https://doi.org/10.1007/s11605-014-2463-y

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