Single‐incision laparoscopic surgery for rectal cancer: early results and medium‐term oncological outcome

Gash, K; Bicsak, Monica; Dixon, A. R.

doi:10.1111/codi.13034

Cited by 16 publications

(9 citation statements)

References 42 publications

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“…In the present study, 7 cases of low anterior resection for distal sigmoid colon cancer were enrolled in RPLS group. Although the safety and technical feasibility of SILS low anterior resection has been reported [ 21 22 ], until now those factors had not yet been established. Actually, applying laparoscopic linear stapler through a single port for rectal transection does not permit sufficient distal resection margin and is sometimes physically and technically impossible in a narrow pelvis.…”

Section: Discussionmentioning

confidence: 99%

Reduced port laparoscopic surgery for colon cancer is safe and feasible in terms of short-term outcomes: comparative study with conventional multiport laparoscopic surgery

et al. 2016

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PurposeLaparoscopic surgery was previously accepted as an alternative surgical option in treatment for colorectal cancer. Nowadays, single-port laparoscopic surgery (SPLS) is introduced as a method to maximize advantages of minimally invasive surgery. However, SPLS has several limitations compared to conventional multiport laparoscopic surgery (CMLS). To overcome those limitations of SPLS, reduced port laparoscopic surgery (RPLS) was introduced. This study aimed at evaluating the short-term outcomes of RPLS.MethodsPatients who underwent CMLS and RPLS of colon cancer between August 2011 and December 2013 were included in this study. Short-term clinical and pathological outcome were compared between the 2 groups.ResultsThirty-two patients underwent RPLS and 217 patients underwent CMLS. Shorter operation time, less blood loss, and faster bowel movement were shown in RPLS group in this study. In terms of postoperative pain, numeric rating scale (NRS) of RPLS was lower than that of CMLS. Significant differences were shown in terms of tumor size, harvested lymph node, perineural invasion, and pathological stage. No significant differences were confirmed in terms of other surgical outcomes.ConclusionIn this study, RPLS was technically feasible and safe. Especially in terms of postoperative pain, RPLS was comparable to CMLS. RPLS may be a feasible alternative option in selected patients with colon cancer.

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Section: Discussionmentioning

confidence: 99%

Reduced port laparoscopic surgery for colon cancer is safe and feasible in terms of short-term outcomes: comparative study with conventional multiport laparoscopic surgery

et al. 2016

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“…Regarding primary outcomes, the two groups had comparable oncological results, including 5-year overall survival, local recurrence, and metastatic rate; even though, compared with the published literature, this study had higher local recurrence rates (LR) at 11-15%, [26][27][28], and this may be explained by the fact that none of the patients in this study had neoadjuvant therapy because the patients who received neoadjuvant in same period had local recurrence rate of 8%. A study by Gash KM et al reported a 4.9% local recurrence rate using the single-port technique after neoadjuvant therapy; [29] however, the 13% LR rate in postoperative radiotherapy (RT) found in the study by Saur et al was reasonably similar to the LR in this series [27]. Other factors often considered to potentially increase the risk of recurrence, such as male sex and high BMI, which were not significantly different in the two groups in this study.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Survival between Single-Access and Conventional Laparoscopic Surgery in Rectal Cancer

Sirikurnpiboon

2021

Minimally Invasive Surgery

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Introduction. Innovative laparoscopic surgery for rectal cancer can be classified into 2 types: firstly, new instruments such as robotic surgery and secondly, new technique such as single-access laparoscopic surgery (SALS) and transanal total mesorectal excision (TaTME). Most reports of SALS for rectal cancer have shown pathologic outcomes comparable to those of conventional laparoscopic surgery (CLS); however, SALS is considered to be superior to CLS in terms of lower levels of discomfort and faster recovery rates. This study aimed to compare the survival outcomes of the two approaches. Methods. From 2011 to 2014, 84 cases of adenocarcinoma of the rectum and anal canal were enrolled. The operations were anterior, low anterior, intersphincteric, and abdominoperineal resections. Data collected included postoperative outcomes. The oncological outcomes recorded included 3-year and 5-year survival, local recurrence, and metastasis. Results. SALS was performed on 41 patients, and CLS was utilized in 43 cases. The demographic data of the two groups were similar. Intraoperative volumes of blood loss and conversion rates were similar, but operative time was longer in the SALS group. There were no significant differences in postoperative complications or pathological outcomes. The oncologic results were similar in terms of 3-year survival (100% and 97.7%; p = 1.00), 5-year survival (78.0% and 86.0%; p = 0.401), local recurrence rates (19.5% vs 11.6%, p = 0.376), and metastasis rates (19.5% vs 11.6%; p = 0.376) for SALS and CLS, respectively. Conclusion. SALS and CLS for rectal and anal cancer had comparable pathological and survival results, but SALS showed some superior benefits in the early postoperative period.

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“…However, 16.8% in the SPS group had required an additional port to complete the operation, due to fixation of tumor, severe pelvic fibrosis or distal rectum division. In a previous study, the conversion rate of SPS for rectal cancer was 8% (18). Hirano et al reported that SPS plus one port was safe and feasible for rectal cancer to overcome the technical difficulties, including mobilization and rectum division (19).…”

Section: Discussionmentioning

confidence: 99%

Systematic review of single‑port vs. multi‑port surgery for rectal cancer

et al. 2020

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The aim of the current systematic review was to compare the short-term clinical and oncological outcomes of single-port surgery (SPS) to multi-port surgery (MPS) for rectal cancer in MEDLINE, PubMed and Cochrane Library from January 2010 to December 2018. A total of 5 clinical controlled studies composed one randomized pilot study and four non-randomized studies with a total of 461 patients were analyzed after a systematic review. A total of 125 patients (27.1%) underwent SPS and 336 patients (72.9%) underwent MPS for rectal cancer. The rate of conversion to open surgery was lower in the SPS group compared with the MPS group (0.8 vs. 5.4%, respectively). A total of 16.8% of patients in the SPS group required an additional port to complete the operation. The morbidity rate was lower in the SPS group compared with the MPS group (28.0 vs. 39.0%, respectively). The other short-term clinical outcomes were similar in both groups. The R0 resection rate was 99.0% in the SPS group and 98.7% in the MPS group. The oncological clearance was satisfactory and similar in both groups. The current study concluded that SPS can be performed safely and provide satisfactory oncological outcomes in patients with rectal cancer. However, further studies are required to determine the role of SPS in the long-term clinical and oncological outcomes.

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Single‐incision laparoscopic surgery for rectal cancer: early results and medium‐term oncological outcome

Abstract: Anterior resection with TME for rectal cancer can be safely performed using the SILS technique, with acceptable histopathological results and good oncological outcome.

Cited by 16 publications

References 42 publications

Reduced port laparoscopic surgery for colon cancer is safe and feasible in terms of short-term outcomes: comparative study with conventional multiport laparoscopic surgery

Reduced port laparoscopic surgery for colon cancer is safe and feasible in terms of short-term outcomes: comparative study with conventional multiport laparoscopic surgery

Comparison of Survival between Single-Access and Conventional Laparoscopic Surgery in Rectal Cancer

Systematic review of single‑port vs. multi‑port surgery for rectal cancer

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