Single-incision versus conventional laparoscopic sigmoid colectomy: a case-matched series

Ramos-Valadez, Diego I.; Ragupathi, Madhu; Nieto, Javier; Patel, Chirag B.; Miller, Steven E.; Pickron, T. Bartley; Haas, Eric M.

doi:10.1007/s00464-011-1833-8

Cited by 73 publications

(40 citation statements)

References 41 publications

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“…A number of reports have demonstrated its advantages in reducing the number of laparoscopic ports, including better cosmetic results, reduced postoperative pain and shorter recovery time (31)(32)(33)(34)(35). In the current study, no statistically significant differences in short-term outcomes were found between elderly colon cancer patients who underwent MLS and SLS.…”

Section: Discussioncontrasting

confidence: 47%

Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

et al. 2016

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Abstract. The safety of single-incision laparoscopic surgery (SLS) in elderly patients with colorectal cancer has not been established. The aim of the current study was to compare the outcomes of SLS and multi-port laparoscopic surgery (MLS) and to assess the feasibility of SLS in colorectal cancer patients aged ≥70 years. A retrospective case-control study of colon cancer patients undergoing elective surgical intervention between 2011 and 2014 was conducted. A total of 129 patients with colon cancer underwent surgery and were included in the analysis. Data regarding patient demographics, surgical variables, oncological outcomes and short-term outcomes were evaluated for statistical significance to compare MLS (n=79) and SLS (n=50) in colon cancer patients. No significant differences were observed in patient characteristics. No case required re-admission within 30 days post surgery. The mean surgery times were similar for the MLS and SLS groups when cases with left and right hemicolectomies were combined (207.7 and 215.9 min, respectively; P= 0.47). In addition, overall perioperative outcomes, including blood loss, number of lymph nodes harvested, size of the surgical margin and complications, were similar between these groups. Thus, we suggest that SLS can be performed safely in elderly patients with colon cancer.

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Section: Discussioncontrasting

confidence: 47%

Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

et al. 2016

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“…Some reports have successfully mentioned its advantages in reducing the number of laparoscopic ports, including better cosmetic results, reduced postoperative pain, and shorter recovery time. [13][14][15][16][17] To our knowledge, this is the first reported case of SILSþ1 TPE for advanced rectal cancer.…”

Section: Discussionmentioning

confidence: 72%

Single-Incision Plus One Port Laparoscopic Total Pelvic Exenteration After Neoadjuvant Chemotherapy for Advanced Primary Rectal Cancer: A Case Report

Tokuoka

Ide

Yamato

et al. 2015

International Surgery

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Limited data on laparoscopic and robotic total pelvic exenteration (TPE) for gynecologic, urologic, and rectal malignancies have been published in the literature. Single-incision laparoscopic surgery (SILS) has been successfully introduced for colon cancer. Here, we describe our experience of TPE with SILS þ 1 port (SILSþ1) for advanced rectal cancer. A 64-year-old man was referred to our hospital with anemia. Computed tomography (CT) revealed a rectal tumor that was contiguous with the seminal vesicle and bladder. Rectoscopy revealed an ulcerated, bleeding, and stricturing lesion in the rectum, which was defined as an adenocarcinoma with a moderate degree of differentiation on histologic examination. The patient received neoadjuvant chemotherapy using capecitabine, oxaliplatin, and bevacizumab. After 3 courses of chemotherapy, a rectovesical fistula was suspected from examination of CT images. CT demonstrated intramural gas in the urinary bladder, which suggested a diagnosis of emphysematous cystitis. Thus, we constructed a transverse loop colostomy. Two months after the last administration of chemotherapy, we performed SILSþ1 TPE. The procedure involved a 35-mm incision in the right side of the umbilicus for the insertion of a single multichannel port, and insertion of a 12-mm port into the right lower quadrant. Total operating time was 751 minutes, and estimated blood loss was 1100 mL (including urine). SILSþ1 TPE is a Corresponding author: Masayoshi Tokuoka, MD, 1-3-1, Ryuge, Yao-city, Osaka 581-0069, Japan. Key words: Single-incision laparoscopic total pelvic exenteration -Rectal cancer -Reduced port surgery S ingle-incision laparoscopic surgery (SILS) has been successfully introduced for colectomy. [1][2][3][4][5] Total pelvic exenteration (TPE) is the only curative procedure for T4 rectal cancer that directly invades the urinary or gynecologic tract. 6 Cases of laparoscopic and robotic TPE for urologic or gynecologic malignancies have been reported, [7][8][9][10] and multiport laparoscopic TPE for advanced rectal cancer has been reported.11 However, SILS plus 1 port (SILSþ1) TPE for advanced primary rectal cancer has not been examined. In this report, we describe the SILSþ1 TPE for advanced primary rectal cancer. Patient and MethodsA 64-year-old man was referred to our hospital with anemia. Physical examination and urine and blood tests revealed hemoglobin of 5.7 g/dL. Computed tomography (CT) revealed a rectal tumor (Fig. 1a) that was contiguous with the seminal vesicle and bladder (Fig. 1b). Rectoscopy revealed an ulcerated, bleeding, and stricturing lesion in the rectum with 9 cm from anal verge, which was defined as an adenocarcinoma with a moderate degree of differentiation on histologic examination (Fig. 2). The level of carcinoembryonic antigen (CEA) was 25 ng/mL. The patient received neoadjuvant chemotherapy using capecitabine, oxaliplatin, and bevacizumab without radiotherapy. After 3 courses of chemotherapy, the patient had fecaluria. A rectovesical fistula was suspected from examination of CT i...

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“…Some reports have successfully mentioned advantages in reducing the number of laparoscopic ports, including better cosmetic results, reduced postoperative pain, and shorter recovery time; however, there are some technical complexities, such as instrument crowding, insufficient counter traction. [11][12][13][14][15][16] For rectal cancer, cases where laparoscopic surgery was performed using SILS þ 1 10 and where TME þ LPLD was performed with multiport laparoscopic surgery 17 have been reported, both of which take advantage of laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer—A Medial Umbilical Ligament Approach

Tokuoka

Ide

Takeda

et al. 2015

International Surgery

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We prove the safety and feasibility of single-incision plus 1 port (SILSþ1) laparoscopic total mesorectal excision (TME) þ lateral pelvic lymph node dissection (LPLD) via a medial umbilical approach for rectal cancer. Only a few reports have been published about single-incision multiport laparoscopic low anterior resection with LPLD. Recently, minimally invasive surgery such as single-incision plus 1 port (SILS þ 1) for advanced rectal cancer has been reported as safe and feasible. To our knowledge, this is the first reported case of SILS þ 1 used for LPLD. A wound protector was inserted through a 30-mm transumbilical incision. Next, a single-port access device was mounted to the wound protector and 3 ports (5 mm each) were placed. A 12-mm port was inserted in the right lower quadrant. Super-low anterior resection of the rectum and bilateral LPLD and temporary ileostomy were performed with SILS þ 1, with a blood loss of 50 mL and a total surgical time of 525 minutes. The time for right lateral dissection was 74 minutes; the time for left lateral dissection was 118 minutes. The total number of dissected lymph nodes was 57 and the number of lateral lymph nodes dissected was 21 (8 left pelvic lymph nodes, 13 right pelvic lymph nodes). No postoperative anastomotic insufficiency or voiding dysfunction was observed. We have documented the safety and feasibility of SILS þ 1-TME þ LPLD via a medial umbilical approach for rectal cancer.

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Single-incision versus conventional laparoscopic sigmoid colectomy: a case-matched series

Cited by 73 publications

References 41 publications

Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

Single-Incision Plus One Port Laparoscopic Total Pelvic Exenteration After Neoadjuvant Chemotherapy for Advanced Primary Rectal Cancer: A Case Report

Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer—A Medial Umbilical Ligament Approach

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