BACKGROUND: Previous randomized trials have assessed the effectiveness of triclosan-coated sutures in fascia closure after midline laparotomy in preventing surgical site infections (SSIs); however, available evidence remain inconclusive. We aimed to evaluate the effectiveness of triclosan-coated sutures in abdominal fascia closure to prevent postoperative SSIs. STUDY DESIGN: This study was a multicenter prospective trial conducted within 24 Japanese secondary and tertiary care centers and a propensity score (PS)–matched analysis. Patients 20 years of age or older who underwent elective surgery for colorectal cancer (CRC) were included. Between July 2016 and July 2019, 2,207 patients were prospectively enrolled into the triclosan-coated sutures or uncoated sutures groups. The per-protocol population comprised 2,195 patients. The PS matching was performed for 1,579 patients: 926 patients in the coated group and 653 patients in the uncoated group. The abdominal fascia after midline laparotomy was closed with triclosan-coated or uncoated sutures depending on group. The primary endpoint was the incidence of an SSI. Secondary endpoints were length of hospital stay and surgical complication rates. RESULTS: The recorded SSI rates were 4.2% in the triclosan-coated group and 6.74% in the uncoated suture group (p = 0.028). There were no serious adverse events in the groups. The final logistic regression model showed that several variables affected the occurrence of SSI. Our meta-analysis included six phase-III trials, and our study evaluated 4,797 patients. The results show a significant superiority of triclosan-coated sutures over uncoated suture material. CONCLUSION: Triclosan-coated sutures reduce the incidence of SSI after elective CRC surgery.

An 85‐year‐old woman presented with a stomachache after a meal and was admitted to the previous clinic. Multi‐detector computed tomography (CT) of the abdomen showed wall thickening in the rectum and right ectopic pelvic kidney. Colonoscopy revealed a mass at the rectum, and a biopsy showed adenocarcinoma. CT showed no lymphadenopathy or distant metastasis. Hartmann's procedure with fluorescent near‐infrared ray ureteral catheters was used to avoid causing urinary injury. Robotic surgery was performed while checking the route of the ureter in near‐infrared mode. The patient was discharged on postoperative day 14 without specific complications. This case appears to be the first of robot‐assisted laparoscopic surgery for a rectal cancer patient with pelvic kidney.

Purpose: Single-incision laparoscopic surgery (SILS) for descending colon cancer (DCC) is a technically challenging procedure with unclear clinical impact. The aim of this study was to evaluate the short-term outcomes of SILS for DCC compared with multi-port laparoscopic surgery (MPLS).Methods: We retrospectively analyzed 137 consecutive patients with stage I–III DCC who underwent SILS or MPLS at two high-volume multidisciplinary tertiary hospitals between April 2008 and December 2018, using propensity score-matched analysis.Results: After propensity score-matching, we enrolled 88 patients (n=44 in each group). Median follow-up period was 48 months. The completion rate for SILS was 98.1% in the overall cohort and 97.7% in the matched cohort. One patient was converted to open surgery in the MPLS group. Compared with the MPLS group, the SILS group showed significantly less blood loss and a greater number of harvested lymph nodes in both the entire patient cohort and the matched cohort. Morbidity rates did not differ significantly between groups before and after matching. R0 resection was achieved in the entire patient cohort. In terms of the incidence of recurrence, both groups were similar before and after matching. No significant differences were found between groups in terms of 3-year disease-free and overall survival rates in either the entire patient cohort or the matched cohort.Conclusions: SILS appears safe and feasible and can provide satisfactory oncological outcomes for selected patients with DCC.