Article

Single-Incision Laparoscopic Colectomy for Cancer: Short-Term Outcomes and Comparative Analysis

Division of Minimally Invasive Colon and Rectal Surgery, Department of Surgery, The University of Texas Medical School at Houston, Houston, TX, USA
Minimally Invasive Surgery 05/2013; 2013(3):283438. DOI: 10.1155/2013/283438
Source: PubMed

ABSTRACT

Introduction. Single-incision laparoscopic colectomy (SILC) is a viable and safe technique; however, there are no single-institution studies comparing outcomes of SILC for colon cancer with well-established minimally invasive techniques. We evaluated the short-term outcomes following SILC for cancer compared to a group of well-established minimally invasive techniques. Methods. Fifty consecutive patients who underwent SILC for colon cancer were compared to a control group composed of 50 cases of minimally invasive colectomies performed with either conventional multiport or hand-assisted laparoscopic technique. The groups were paired based on the type of procedure. Demographics, intraoperative, and postoperative outcomes were assessed. Results. With the exception of BMI, demographics were similar between both groups. Most of the procedures were right colectomies (n = 33) and anterior resections (n = 12). There were no significant differences in operative time (127.9 versus 126.7 min), conversions (0 versus 1), complications (14% versus 8%), length of stay (4.5 versus 4.0 days), readmissions (2% versus 2%), and reoperations (2% versus 2%). Oncological outcomes were also similar between groups. Conclusions. SILC is an oncologically sound alternative for the management of colon cancer and results in similar short-term outcomes as compared with well-established minimally invasive techniques.

Download full-text

Full-text

Available from: Rodrigo Pedraza, Nov 28, 2015
  • Source
    • "With regards to survival, Papaconstantinou et al[5]reported that the mean followups were 13 and 21 mo for the SILC and CLC groups, respectively, and that the recurrence rates and diseasefree survivals (DFSs) at 1 year were equivalent in both groups. Yun et al[15]showed that the mean follow-up periods were 24.5 mo for the SILC group and 26.4 mo for the CLC group, and that the recurrence rates and DFSs at 2 years did not differ significantly between the two groups. Comparison of long-term survival following SILC and CLC for colorectal cancer is clearly an important area for future research. "

    Preview · Article · Jan 2016
  • [Show abstract] [Hide abstract]
    ABSTRACT: Single incision laparoscopic surgery (SILS) has not been sufficiently evaluated with respect to its oncologic equivalence to conventional laparoscopic or open surgery. In 87 out of 507 patients who had SILS for colorectal diseases in our institution, 87 had segmental resection for colorectal adenocarcinoma. For each of the surgical specimens the number of lymph nodes which can be expected to be identified by the pathologist was calculated using the ACPGBI lymph node harvest model, which was developed from a nationwide database of 5845 surgical specimens. The predicted number of lymph nodes was compared with the number identified in our SILS specimens. The median predicted number of lymph nodes was 11 (4.5-14.8) compared with 18 (5-44) in the SILS specimens (p<0.001). In all subgroups analyzed for various operations, the lymph node harvest in the SILS specimens was significantly higher than predicted. In terms of lymph node harvest SILS seems to be comparable to conventional open or laparoscopic surgery. This article is protected by copyright. All rights reserved.C.
    No preview · Article · Dec 2013 · Colorectal Disease
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Single-port laparoscopic surgery (SPLS) is implemented through a tailored minimal single incision through which a number of laparoscopic instruments access. Introduction of operation-customized port system, utilization of a camera without a separate external light, and instruments with different lengths has brought the favorable environment for SPLS. However, performing SPLS still creates several hardships compared to multiport laparoscopic surgery; a single-port system inevitably leads to clashing of surgical instruments due to crowding. To overcome such difficulties, investigators has developed novel concepts and maneuvers, including the concept of inverse triangulation and the maneuvers of pivoting, spreading out dissection, hanging suture, and transluminal traction. The final destination of SPLS is expected to be a completely seamless operation, maximizing the minimal invasiveness. Specimen extraction through the umbilicus can undermine cosmesis by inducing a larger incision. Therefore, hybrid laparoscopic technique, which combined laparoscopic surgical technique with natural orifice specimen extraction (NOSE) - i.e., transvaginal or transanal route-, has been developed. SPLS and NOSE seemed to be the best combination in pursuit of minimal invasiveness. In the near future, robotic SPLS with natural orifice transluminal endoscopic surgery's way of specimen extraction seems to be pursued. It is expected to provide a completely or nearly complete seamless operation regardless of location of the lesion in the abdomen.
    Full-text · Article · Jan 2014 · World Journal of Gastroenterology
Show more