Single-Incision Versus Standard Multiport Laparoscopic Colectomy

Champagne, Bradley J.; Papaconstantinou, Harry T.; Parmar, Stavan S.; Nagle, Deborah; Young‐Fadok, Tonia M.; Lee, Edward C.; Delaney, Conor P.

doi:10.1097/sla.0b013e3182378442

Cited by 191 publications

(155 citation statements)

References 16 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: 39%

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: 39%

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: 99%

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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“…К насто-ящему времени в мире накоплен существенный опыт та-ких вмешательств [10][11][12][13][14][15][16][17][18][19][20][21]. Пожалуй, наиболее репрезен-тативную выборку (521 SILS и 634 стандартных лапаро-скопических вмешательств при раке ободочной и прямой кишки) представили авторы из Китая, обобщив данные одного проспективного рандомизированного [22] и 13 не-рандомизированных исследований [23]. В подавляющем большинстве работ представляемый опыт не превышает 40 операций, выполненных с помощью технологии еди-ного доступа.…”

Section: результаты и обсуждениеunclassified

Evaluation of the results of unique laparoscopic access surgery versus standard laparoscopic interventions for colorectal cancer

Lyadov¹,

Егиев²,

Lyadov³

et al. 2015

Onkol. Z. im. P.A. Gercena

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20Лапароскопические технологии нашли широкое при-менение в хирургии рака ободочной и прямой кишки и являются одним из наиболее динамично развивающихся методов хирургического лечения. Производителями меди-цинских инструментов представлена целая серия техноло-гий, позволяющих выполнять миниинвазивные оператив-ные вмешательства при опухолевых заболеваниях толстой кишки. В настоящее время актуальным является решение вопроса о предпочтении применения той или иной мето-дики оперативного вмешательства у конкретного пациента. Цель -провести ретроспективный анализ результатов операций при раке ободочной и прямой кишки, выполненных по методике единого лапароскопического доступа и по стандартной лапароскопической технологии. Материал и методы. В исследование включили 110 лапароскопических операций, выполненных в Лечебно-реабилитационном центре за пери-од с марта 2009 г. по декабрь 2013 г. Из них 44 операции выполнены по методике единого лапароскопического доступа (1-я группа) и 66 -по стандартной лапароскопической технологии (2-я группа). Статистически значимых различий между группами по полу, возрасту, индексу массы тела, локализации, размеру и стадии опухоли не выявлено. Чаще в качестве порта для единого доступа использовали SILS-порт. Удаление препарата и формирование анастомоза осуществляли через трансумбиликальный доступ. При стандартных лапароскопических операциях препарат удаляли через поперечный доступ над лоном. Результаты. Статистически значимых различий по основным оцениваемым показателям не выявлено. Тяжелые осложнения выявлены у 16 и 12% пациентов соответственно. Средняя продолжительность послеоперационного койко-дня составила 7 и 8 сут соответственно. В каждой группе отмечено по одному летальному исходу. Удовлетворенность кос-метическим эффектом (5 и 4 балла) в 1-й и 2-й группах составила 98,6 и 96,4% соответственно. Возращение к обычному образу жизни в течение 3 нед отмечено у 79,0 и 76,8% больных соответственно. Заключение. Применение технологии единого доступа в хирургии рака ободочной и прямой кишки позволяет добиться результатов, не уступающих результатам стандартных лапароскопических вмешательств. Дальнейшие сравнительные исследования позволят прояснить роль этой технологии в комплексном лечении пациентов. Ключевые слова: однопрокольные операции, единый лапароскопический доступ, рак прямой и ободочной кишки, хирур-гическое лечение.Objective: to retrospectively analyze the results of unique laparoscopic access surgery versus standard laparoscopic surgery for colorectal cancer. Subjects and methods. The investigation enrolled 110 laparoscopic operations performed in the Medical and Rehabilitation Center in March 2009 to December 2013. Out of them, 44 operations were made using a unique laparoscopic approach (Group 1) and 66 operations by standard laparoscopic technology (Group 2). No statically significant differences were found between the groups in gender, age, body mass index, and tumor site, size, and grade. The SILS port was more commonly used for the unique approach. A transumbilical approach was us...

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Single-Incision Versus Standard Multiport Laparoscopic Colectomy

Cited by 191 publications

References 16 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

Evaluation of the results of unique laparoscopic access surgery versus standard laparoscopic interventions for colorectal cancer

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