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

Tokuoka, Masayoshi; Ide, Yoshihito; Takeda, Mitsunobu; Hashimoto, Yasuji; Matsuyama, Jin; Yokoyama, Shigekazu; Fukushima, Yukio; Sasaki, Yo

doi:10.3892/ol.2016.4802

Cited by 14 publications

(13 citation statements)

References 38 publications

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“…This study demonstrated that, in selected patients, acceptable outcomes could be achieved in nonagenarian patients. The postoperative mortality in this series was comparable to that previously reported in the literature [17]. The 30-day mortality rate after elective resections in the nonagenarian patients was comparable to that of the younger elderly population.…”

Section: Discussionsupporting

confidence: 85%

Outcomes of colorectal cancer surgery in the nonagenarians: 20-year result from a tertiary center

et al. 2019

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BackgroundThere is a foreseeable trend that life expectancy is on the rise in many parts of the world. More and more patients will present with colorectal cancer at extreme old age and advanced age is a well-known risk factor for adverse outcomes after surgery. The aim of this study is to evaluate the outcomes of colorectal cancer surgery in patients aged 90 or above.MethodA retrospective analysis of consecutive patients aged 90 or above who underwent operations for colorectal cancer between January 1996 and December 2015 was performed. The primary outcomes were the complications rate, 30-day and 180-day mortality rates.ResultsA total of 57 patients were included in the analysis. The majority of them were women (64.9%). The median age was 92 years. Most of the surgery was of curative intent (77.2%), performed under elective setting (57.9%) and with open approach (78.9%). 36.8% of patients had postoperative complications, with pneumonia being the commonest. The 30-day and 180-day mortality rate was 7 and 31.6% respectively. History of ischemic heart disease and surgery under emergency setting were predictors of postoperative complications. Pneumonia, preoperative leukocytosis and Charlson comorbidity score ≥ 9 were predictors of 180-day mortality. The one and two-year survival rate for elective surgery was 69.7 and 54.5% respectively.ConclusionThe outcomes of colorectal cancer surgery for nonagenarians could be favorable in a selected group of patients. Future study on better risk profiling and ways to improve outcomes is warranted.

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Section: Discussionsupporting

confidence: 85%

Outcomes of colorectal cancer surgery in the nonagenarians: 20-year result from a tertiary center

et al. 2019

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“…Li et al indicated SILS had less blood loss and longer operative time compared with our study. We think a surgeon could increase operative time due to variation of blood vessels in the right colon [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Systematic review of single-incision versus conventional multiport laparoscopic surgery for sigmoid colon and rectal cancer

Liu

Shi

et al. 2018

World J Surg Onc

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ObjectivesTo explore whether single-incision laparoscopic surgery (SILS) has the better short-term clinical and pathological outcomes than conventional multiport laparoscopic surgery (CLS) for sigmoid colon and rectal cancer.MethodsA literature investigation of MEDLINE, PubMed, Ovid, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Chinese Biological Medicine (CBM), and Wanfang databases for relevant researches was performed. Fixed effects and random effects models were used to calculate the corresponding outcomes. Standardized mean difference and risk ratio were calculated for continuous and dichotomous variables separately.ResultsNine clinical controlled trials were composed of two randomized clinical trials and seven non-randomized clinical trials with a total of 829 patients. Two hundred ninety-nine (36.1%) patients underwent SILS, and 530 (63.9%) patients underwent CLS. The meta-analysis showed that SILS had more lymph node resection (SMD − 0.25, 95% CI − 0.50 to − 0.002) and less defecation time (SMD − 0.46, 95% CI − 0.75 to − 0.17), exhaust time (SMD − 0.46, 95% CI − 0.75 to − 0.18), and hospital stay (SMD − 0.30, 95% CI − 0.45 to − 0.15 than CLS. SILS was also accompanied with shorter incision length (SMD − 2.46, 95% CI − 4.02 to − 0.90), less pain score (SMD − 0.56, 95% CI − 0.91 to − 0.21), and lower complication rate (RR 0.66, 95% CI 0.47 to 0.91). Blood loss, operative time, distal margin, conversion rate, anastomotic fistula, readmission, local recurrence, and distant metastasis showed no statistical differences in two groups. In all subgroup analysis, SILS also had advantages of incision length, operative time, defecation time, exhaust time, and hospitalization time than CLS.ConclusionSILS could be a more safe and reliable surgical technique than CLS for sigmoid colon and rectal cancer. However, further high-quality studies between these two techniques need to be further developed.

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“…Although the median BMI in all patients was 27.6, which is somewhat high and indicates slight obesity, complications during surgery or due to the conversion to laparotomy were not observed, and we were able to safely perform surgery. Compared to the results that previously reported about laparoscopic surgery for colorectal cancers, 16,17 all variables were similar and laparoscopic colorectal resection with 2 anastomotic sites were shown to be sufficiently safe and minimally invasive.…”

Section: Discussionmentioning

confidence: 45%

Utility of Laparoscopic Surgery for Multiple Synchronous Colorectal Cancers With Two Anastomotic Sites

Takeda

Ide²,

Tokuoka³

et al. 2017

International Surgery

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The frequency of multiple synchronous colorectal cancers is reported to be 2% to 7%. The surgical resection of 2 lesions and having 2 anastomotic sites are rare. According to previous studies, even if there are 2 anastomotic sites, the rate of complications associated with laparotomy will not increase. However, the number of studies confined to cases of laparoscopic surgery is limited. This study investigated effective methods for laparoscopic colorectal resection and their short-term results in cases of multiple synchronous colorectal cancers with 2 anastomotic sites. The safety of these methods were also evaluated. The study was comprised of 4 patients with multiple synchronous colorectal cancers who underwent resection using laparoscopy between January 2011 and March 2015. We retrospectively examined patients with 2 anastomosis sites. A total of 3 patients underwent multiport laparoscopic surgery (5-port) and 1 patient underwent single-port laparoscopic surgery. Complications due to the conversion to laparotomy or intraoperative or postoperative complications were not observed in any patient. Laparoscopic colorectal resection, resulting in 2 anastomosis sites, was performed safely. Compared to open colorectal resection with 2 anastomotic sites, laparoscopic resection was a smaller incision and minimally invasive. Therefore, laparoscopic colorectal resection with 2 anastomotic sites is regarded as a feasible and safe option for multiple synchronous colorectal cancers when tumors are located distantly from each other.

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

Cited by 14 publications

References 38 publications

Outcomes of colorectal cancer surgery in the nonagenarians: 20-year result from a tertiary center

Outcomes of colorectal cancer surgery in the nonagenarians: 20-year result from a tertiary center

Systematic review of single-incision versus conventional multiport laparoscopic surgery for sigmoid colon and rectal cancer

Utility of Laparoscopic Surgery for Multiple Synchronous Colorectal Cancers With Two Anastomotic Sites

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