Browse > Article
http://dx.doi.org/10.3393/ac.2018.04.06

Clinical Outcomes of Reduced-Port Laparoscopic Surgery for Patients With Sigmoid Colon Cancer: Surgery With 1 Surgeon and 1 Camera Operator  

Oh, Jung Ryul (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Park, Sung Chan (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Park, Sung Sil (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Sohn, Beonghoon (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Oh, Hyoung Min (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Kim, Bun (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Kim, Min Jung (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Hong, Chang Won (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Han, Kyung Su (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Sohn, Dae Kyung (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Oh, Jae Hwan (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
Publication Information
Annals of Coloproctology / v.34, no.6, 2018 , pp. 292-298 More about this Journal
Abstract
Purpose: This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator. Methods: From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery. Results: Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time ($137.4{\pm}43.2minutes$ vs. $155.5{\pm}47.9minutes$, P < 0.001) and shorter incision length ($5.3{\pm}2.2cm$ vs. $7.8{\pm}1.2cm$, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size. Conclusion: RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.
Keywords
Reduced-port laparoscopic surgery; Sigmoid colon cancer; Colectomy; One surgeon plus one camera operator surgery; Three-port surgery;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 2005; 365:1718-26.   DOI
2 Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 2002;359:2224-9.   DOI
3 Neudecker J, Klein F, Bittner R, Carus T, Stroux A, Schwenk W, et al. Short-term outcomes from a prospective randomized trial comparing laparoscopic and open surgery for colorectal cancer. Br J Surg 2009;96:1458-67.   DOI
4 Bresadola F, Pasqualucci A, Donini A, Chiarandini P, Anania G, Terrosu G, et al. Elective transumbilical compared with standard laparoscopic cholecystectomy. Eur J Surg 1999;165:29-34.   DOI
5 Piskun G, Rajpal S. Transumbilical laparoscopic cholecystectomy utilizes no incisions outside the umbilicus. J Laparoendosc Adv Surg Tech A 1999;9:361-4.   DOI
6 Rispoli G, Armellino MF, Esposito C. One-trocar appendectomy. Surg Endosc 2002;16:833-5.   DOI
7 Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR, et al. Single-port laparoscopic surgery in urology: initial experience. Urology 2008;71:3-6.   DOI
8 Yu H, Shin JY. Short-term outcomes following reduced-port, single-port, and multi-port laparoscopic surgery for colon cancer: tailored laparoscopic approaches based on tumor size and nodal status. Int J Colorectal Dis 2016;31:115-22.   DOI
9 Choi SI, Lee KY, Park SJ, Lee SH. Single port laparoscopic right hemicolectomy with D3 dissection for advanced colon cancer. World J Gastroenterol 2010;16:275-8.   DOI
10 Poon JT, Cheung CW, Fan JK, Lo OS, Law WL. Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized, controlled trial. Surg Endosc 2012;26:2729-34.   DOI
11 Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004;240:205-13.   DOI
12 Kim SJ, Choi BJ, Lee SC. Overview of single-port laparoscopic surgery for colorectal cancers: past, present, and the future. World J Gastroenterol 2014;20:997-1004.   DOI
13 Makino T, Milsom JW, Lee SW. Single-incision laparoscopic surgeries for colorectal diseases: early experiences of a novel surgical method. Minim Invasive Surg 2012;2012:783074.
14 Pascual M, Alonso S, Pares D, Courtier R, Gil MJ, Grande L, et al. Randomized clinical trial comparing inflammatory and angiogenic response after open versus laparoscopic curative resection for colonic cancer. Br J Surg 2011;98:50-9.
15 Bucher P, Pugin F, Morel P. Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis 2008;23:1013-6.   DOI
16 Leroy J, Cahill RA, Peretta S, Marescaux J. Single port sigmoidectomy in an experimental model with survival. Surg Innov 2008; 15:260-5.   DOI
17 Schwenk W, Bohm B, Muller JM. Postoperative pain and fatigue after laparoscopic or conventional colorectal resections. A prospective randomized trial. Surg Endosc 1998;12:1131-6.   DOI
18 Choi DH, Jeong WK, Lim SW, Chung TS, Park JI, Lim SB, et al. Learning curves for laparoscopic sigmoidectomy used to manage curable sigmoid colon cancer: single-institute, three-surgeon experience. Surg Endosc 2009;23:622-8.   DOI