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Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer

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Abstract

Background

Recently, laparoscopic colorectal surgery using a single incision usually made at the umbilical area has emerged as a tool to minimize the numbers of scars and provide better cosmetic results. But experience in laparoscopic skills is needed to maintain the oncologic principles of colorectal cancer surgery with the restricted operating field during the procedure. Adding an additional port to single-incision laparoscopic colorectal surgery (SILS) may be a bridge between conventional multiport laparoscopic surgery and SILS. The present study was undertaken to investigate whether umbilical incision laparoscopic colorectal cancer surgery with one additional port (ULAP) could be performed in a similar manner to conventional multiport surgery.

Methods

One hundred and sixty-three patients with colorectal adenocarcinoma underwent laparoscopic colectomy between February 2011 and August 2011. Forty of these patients underwent ULAP and were compared with the other 123 patients who had conventional laparoscopic surgery. Demographic, intraoperative, and postoperative data were analyzed.

Results

Both groups were similar in age (p = 0.438), gender (p = 0.818), body mass index (p = 0.149), American Society of Anesthesiologists (ASA) scores (p = 0.417), history of previous abdominal operation (p = 0.503), and tumor location (p = 0.051). Operation time was longer in the ULAP group (255.5 min) than in the conventional laparoscopic surgery group (144.6 min) (p < 0.001). No significant differences were evident between groups for estimated blood loss (p = 0.263), transfusion requirements (p = 0.841), conversion to open procedures (p = 0.40), length of umbilical incisions (4.6 vs. 4.4 cm, p = 0.628), postoperative hospital stay (p = 0.862), tumor size (p = 0.455), number of harvested lymph nodes (p = 0.203), proximal margins (p = 0.189), and distal resection margins (p = 0.151). Postoperative morbidity (p = 0.736) was similar in both groups. There was no mortality postoperatively.

Conclusions

Umbilical incision laparoscopic colorectal cancer surgery with an additional port is a feasible and safe approach, although it is more time consuming than conventional laparoscopic colectomy.

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References

  1. Braga M, Frasson M, Zuliani W, Vignali A, Pecorelli N, Di Carlo V (2010) Randomized clinical trial of laparoscopic versus open left colonic resection. Br J Surg 97:1180–1186

    Article  PubMed  CAS  Google Scholar 

  2. Hemandas AK, Abdelrahman T, Flashman KG et al (2010) Laparoscopic colorectal surgery produces better outcomes for high risk cancer patients compared to open surgery. Ann Surg 252:84–89

    Article  PubMed  Google Scholar 

  3. Lacy AM, Garcia-Valdecasas JC, Delgado S et al (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229

    Article  PubMed  Google Scholar 

  4. Kang SB, Park JW, Jeong SY et al (2010) Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol 11:637–645

    Article  PubMed  Google Scholar 

  5. Jayne DG, Guillou PJ, Thorpe H et al (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25:3061–3068

    Article  PubMed  Google Scholar 

  6. Fleshman J, Sargent DJ, Green E et al (2007) Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg 246:655–662 discussion 662–664

    Article  PubMed  Google Scholar 

  7. Katsuno G, Fukunaga M, Nagakari K, Yoshikawa S, Ouchi M, Hirasaki Y (2011) Single-incision laparoscopic colectomy for colon cancer: early experience with 31 cases. Dis Colon Rectum 54:705–710

    Article  PubMed  Google Scholar 

  8. Leblanc F, Champagne BJ, Augestad KM et al (2010) Single incision laparoscopic colectomy: technical aspects, feasibility, and expected benefits. Diagn Ther Endosc 2010:913216

    Article  PubMed  CAS  Google Scholar 

  9. Canes D, Desai MM, Aron M et al (2008) Transumbilical single-port surgery: evolution and current status. Eur Urol 54:1020–1029

    Article  PubMed  Google Scholar 

  10. Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97:1881–1883

    Article  PubMed  CAS  Google Scholar 

  11. Chambers WM, Bicsak M, Lamparelli M, Dixon AR (2011) Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Colorectal Dis 13:393–398

    Article  PubMed  CAS  Google Scholar 

  12. Ross H, Steele S, Whiteford M et al (2011) Early multi-institution experience with single-incision laparoscopic colectomy. Dis Colon Rectum 54:187–192

    Article  PubMed  CAS  Google Scholar 

  13. Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53:284–288

    Article  PubMed  Google Scholar 

  14. Ramos-Valadez DI, Ragupathi M, Nieto J et al (2011) Single-incision versus conventional laparoscopic sigmoid colectomy: a case-matched series. Surg Endosc 26:96–102

    Article  PubMed  Google Scholar 

  15. Champagne BJ, Lee EC, Leblanc F, Stein SL, Delaney CP (2011) Single-incision vs. straight laparoscopic segmental colectomy: a case-controlled study. Dis Colon Rectum 54:183–186

    Article  PubMed  CAS  Google Scholar 

  16. Papaconstantinou HT, Thomas JS (2011) Single-incision laparoscopic colectomy for cancer: assessment of oncologic resection and short-term outcomes in a case-matched comparison with standard laparoscopy. Surgery 150:820–827

    Article  PubMed  Google Scholar 

  17. Geisler D, Garrett T (2011) Single incision laparoscopic colorectal surgery: a single surgeon experience of 102 consecutive cases. Tech Coloproctol 15:397–401

    Article  PubMed  CAS  Google Scholar 

  18. Ragupathi M, Ramos-Valadez DI, Yaakovian MD, Haas EM (2011) Single-incision laparoscopic colectomy: a novel approach through a Pfannenstiel incision. Tech Coloproctol 15:61–65

    Article  PubMed  CAS  Google Scholar 

  19. Adair J, Gromski MA, Lim RB, Nagle D (2010) Single-incision laparoscopic right colectomy: experience with 17 consecutive cases and comparison with multiport laparoscopic right colectomy. Dis Colon Rectum 53:1549–1554

    Article  PubMed  Google Scholar 

  20. Waters JA, Guzman MJ, Fajardo AD et al (2010) Single-port laparoscopic right hemicolectomy: a safe alternative to conventional laparoscopy. Dis Colon Rectum 53:1467–1472

    Article  PubMed  Google Scholar 

  21. Wong MT, Ng KH, Ho KS, Eu KW (2010) Single-incision laparoscopic surgery for right hemicolectomy: our initial experience with 10 cases. Tech Coloproctol 14:225–228

    Article  PubMed  CAS  Google Scholar 

  22. Brunner W, Schirnhofer J, Waldstein-Wartenberg N, Frass R, Weiss H (2010) Single incision laparoscopic sigmoid colon resections without visible scar: a novel technique. Colorectal Dis 12:66–70

    Article  PubMed  CAS  Google Scholar 

  23. Kawahara H, Watanabe K, Ushigome T, Noaki R, Kobayashi S, Yanaga K (2010) Umbilical incision laparoscopic surgery with one assist port for anterior resection. Dig Surg 27:364–366

    Article  PubMed  Google Scholar 

  24. Takemasa I, Sekimoto M, Ikeda M et al (2010) Video. Transumbilical single-incision laparoscopic surgery for sigmoid colon cancer. Surg Endosc 24:2321

    Article  PubMed  Google Scholar 

  25. Bulut O, Nielsen CB, Jespersen N (2011) Single-port access laparoscopic surgery for rectal cancer: initial experience with 10 cases. Dis Colon Rectum 54:803–809

    Article  PubMed  Google Scholar 

  26. Nagpal A, Soni H, Haribhakti S (2011) Single-incision laparoscopic restorative proctocolectomy with ileal pouch anal anastomosis for ulcerative colitis: first Indian experience and literature review. Int J Colorectal Dis 26:525–526

    Article  PubMed  Google Scholar 

  27. Curcillo PG 2nd, Podolsky ER, King SA (2011) The road to reduced port surgery: from single big incisions to single small incisions, and beyond. World J Surg 35:1526–1531

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a grant from Chonnam National University 2010 and Dalim Tech, Seoul, Korea, and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2012010817).

Conflict of interest

Drs. Sang Woo Lim, Hun Jin Kim, Chang Hyun Kim, Jung Wook Huh, Young Jin Kim, Hyeong Rok Kim have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Colon and Rectal Surgery, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Gwangju, Hwasun-gun, Jeollanam-do, 519-763, South Korea

    S. Woo Lim, H. Jin Kim, C. Hyun Kim, J. Wook Huh, Y. Jin Kim & H. Rok Kim

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  1. S. Woo Lim
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  2. H. Jin Kim
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  3. C. Hyun Kim
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  4. J. Wook Huh
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Corresponding author

Correspondence to H. Rok Kim.

Additional information

Poster presentation at the Scientific session of 2012 SAGES annual meeting, 7–10 March 2012, San Diego, CA, USA.

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Lim, S.W., Kim, H.J., Kim, C.H. et al. Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer. Tech Coloproctol 17, 193–199 (2013). https://doi.org/10.1007/s10151-012-0900-z

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  • DOI: https://doi.org/10.1007/s10151-012-0900-z

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