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Published in: Surgical Endoscopy 6/2013

01-06-2013

Single-incision laparoscopic right colectomy compared with conventional laparoscopy for malignancy: assessment of perioperative and short-term oncologic outcomes

Authors: Jung-A Yun, Seong Hyeon Yun, Yoon Ah Park, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee, Ho-Kyung Chun

Published in: Surgical Endoscopy | Issue 6/2013

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Abstract

Background

Laparoscopic colectomy for malignancy currently is the standard operative technique together with open colectomy. Single-incision laparoscopic surgery (SIL) is a recent advance in minimally invasive surgical techniques. This study aimed to compare SIL right colectomy with conventional laparoscopy (CL) used to treat patients with colon cancer.

Methods

This study was a retrospective analysis of data from the authors’ prospectively collected colorectal surgery database. Between August 2009 and November 2010, 159 patients who underwent primary laparoscopic right colectomy at the Samsung Medical Center were recruited to participate in this study. Of these, 66 patients underwent SIL colectomy.

Results

The SIL and CL right colectomy groups did not differ significantly in terms of general characteristics including age, sex, body mass index (BMI), American society of anesthesiology (ASA) score, previous abdominal operation, and diagnosis. The two groups also did not differ significantly in terms of perioperative complications (9.1 vs. 15.1 %, p = 0.335). Oncologic resection was similar in the two groups. The mean number of harvested lymph nodes was 24 for SIL and 27 for CL right colectomy (p = 0.068). Tumor size, disease stage, adjuvant chemotherapy, and proximal and distal resection margins did not differ significantly between the two groups. The mean follow-up period was 24.5 for the SIL group and 26.4 months for the CL group (p = 0.098), with six recurrences in the SIL group (9.1 %) and three recurrences in the CL group (3.2 %) (p = 0.120). One death occurred in the CL group. Disease-free survival at 24 months did not differ significantly between the two groups (89.7 vs. 96.3 %, p = 0.120).

Conclusion

The findings show that SIL right colectomy for colon cancer is safe and can provide resection and oncologic outcomes equal to those of conventional laparoscopic right colectomy.
Literature
1.
go back to reference Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef
2.
go back to reference Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124PubMedCrossRef Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124PubMedCrossRef
3.
go back to reference Delaney CP, Chang E, Senagore AJ, Broder M (2008) Clinical outcomes and resource utilization associated with laparoscopic and open colectomy using a large national database. Ann Surg 247:819–824PubMedCrossRef Delaney CP, Chang E, Senagore AJ, Broder M (2008) Clinical outcomes and resource utilization associated with laparoscopic and open colectomy using a large national database. Ann Surg 247:819–824PubMedCrossRef
4.
go back to reference Bonjer HJ, Hop WC, Nelson H, Sargent DJ, Lacy AM, Castells A, Guillou PJ, Thorpe H, Brown J, Delgado S, Kuhrij E, Haqlind E, Pahlman L (2007) Laparoscopically assisted versus open colectomy for colon cancer: a meta-analysis. Arch Surg 142:298–303PubMedCrossRef Bonjer HJ, Hop WC, Nelson H, Sargent DJ, Lacy AM, Castells A, Guillou PJ, Thorpe H, Brown J, Delgado S, Kuhrij E, Haqlind E, Pahlman L (2007) Laparoscopically assisted versus open colectomy for colon cancer: a meta-analysis. Arch Surg 142:298–303PubMedCrossRef
5.
go back to reference Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G (2002) Short-term quality-of-life outcomes following laparoscopic-assisted colectomy versus open colectomy for colon cancer: a randomized trial. JAMA 287:321–328PubMedCrossRef Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G (2002) Short-term quality-of-life outcomes following laparoscopic-assisted colectomy versus open colectomy for colon cancer: a randomized trial. JAMA 287:321–328PubMedCrossRef
6.
go back to reference Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term end points of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726PubMedCrossRef Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term end points of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726PubMedCrossRef
7.
go back to reference Neudecker J, Klein F, Bittner R, Carus T, Stroux A, Schwenk W (2009) Short-term outcomes from a prospective randomized trial comparing laparoscopic and open surgery for colorectal cancer. Br J Surg 96:1458–1467PubMedCrossRef Neudecker J, Klein F, Bittner R, Carus T, Stroux A, Schwenk W (2009) Short-term outcomes from a prospective randomized trial comparing laparoscopic and open surgery for colorectal cancer. Br J Surg 96:1458–1467PubMedCrossRef
8.
go back to reference Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150PubMed Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150PubMed
9.
go back to reference Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826PubMedCrossRef Remzi FH, Kirat HT, Kaouk JH, Geisler DP (2008) Single-port laparoscopy in colorectal surgery. Colorectal Dis 10:823–826PubMedCrossRef
10.
go back to reference Bucher P, Pugin F, Morel P (2008) Single-port-access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016PubMedCrossRef Bucher P, Pugin F, Morel P (2008) Single-port-access laparoscopic right hemicolectomy. Int J Colorectal Dis 23:1013–1016PubMedCrossRef
11.
go back to reference van den Boezem PB, Sietses C (2011) Single-incision laparoscopic colorectal surgery: experience with 50 consecutive cases. J Gastrointest Surg 15:1989–1994PubMedCrossRef van den Boezem PB, Sietses C (2011) Single-incision laparoscopic colorectal surgery: experience with 50 consecutive cases. J Gastrointest Surg 15:1989–1994PubMedCrossRef
12.
go back to reference Geisler D, Garrett T (2011) Single-incision laparoscopic colorectal surgery: a single-surgeon experience of 102 consecutive cases. Tech Coloproctol 15:397–401PubMedCrossRef Geisler D, Garrett T (2011) Single-incision laparoscopic colorectal surgery: a single-surgeon experience of 102 consecutive cases. Tech Coloproctol 15:397–401PubMedCrossRef
13.
go back to reference Boni L, Dionigi G, Cassinotti E, Di Giuseppe M, Diurni M, Rausei S, Cantore F, Dionigi R (2010) Single-incision laparoscopic right colectomy. Surg Endosc 24:3233–3236PubMedCrossRef Boni L, Dionigi G, Cassinotti E, Di Giuseppe M, Diurni M, Rausei S, Cantore F, Dionigi R (2010) Single-incision laparoscopic right colectomy. Surg Endosc 24:3233–3236PubMedCrossRef
14.
go back to reference 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 150:820–827PubMedCrossRef 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 150:820–827PubMedCrossRef
15.
go back to reference Kim SJ, Ryu GO, Choi BJ, Kim JG, Lee KJ, Lee SC, Oh ST (2011) The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer. Ann Surg 254:933–940PubMedCrossRef Kim SJ, Ryu GO, Choi BJ, Kim JG, Lee KJ, Lee SC, Oh ST (2011) The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer. Ann Surg 254:933–940PubMedCrossRef
16.
go back to reference Nelson H, Petrelli N, Carlin A, Couture J, Fleshman J, Guillem J, Miedema B, Ota D, Sargent D (2001) National cancer institute expert panel guidelines 2000 for colon and rectal cancer surgery. J Natl Cancer Inst 93:583–596PubMedCrossRef Nelson H, Petrelli N, Carlin A, Couture J, Fleshman J, Guillem J, Miedema B, Ota D, Sargent D (2001) National cancer institute expert panel guidelines 2000 for colon and rectal cancer surgery. J Natl Cancer Inst 93:583–596PubMedCrossRef
17.
18.
go back to reference Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer J (2008) Long-term outcome of laparoscopic surgery for colorectal cancer: a Cochrane systematic review of randomised controlled trials. Cancer Treat Rev 34:498–504PubMedCrossRef Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer J (2008) Long-term outcome of laparoscopic surgery for colorectal cancer: a Cochrane systematic review of randomised controlled trials. Cancer Treat Rev 34:498–504PubMedCrossRef
19.
go back to reference Jackson TD, Kaplan GG, Arena G, Page JH, Rogers SO (2007) Laparoscopic versus open resection for colorectal cancer: a metaanalysis of oncologic outcomes. J Am Coll Surg 204:439–446PubMedCrossRef Jackson TD, Kaplan GG, Arena G, Page JH, Rogers SO (2007) Laparoscopic versus open resection for colorectal cancer: a metaanalysis of oncologic outcomes. J Am Coll Surg 204:439–446PubMedCrossRef
20.
go back to reference Whiteford MH, Swanstrom LL (2007) Emerging technologies including robotics and natural orifice transluminal endoscopic surgery (NOTES) colorectal surgery. J Surg Oncol 96:678–683PubMedCrossRef Whiteford MH, Swanstrom LL (2007) Emerging technologies including robotics and natural orifice transluminal endoscopic surgery (NOTES) colorectal surgery. J Surg Oncol 96:678–683PubMedCrossRef
21.
go back to reference Podolsky ER, Curcillo PG II (2010) Single-port-access (SPA) surgery: a 24 month experience. J Gastrointest Surg 14:759–767PubMedCrossRef Podolsky ER, Curcillo PG II (2010) Single-port-access (SPA) surgery: a 24 month experience. J Gastrointest Surg 14:759–767PubMedCrossRef
22.
go back to reference Geisler DP, Condon ET, Remzi FH (2010) Single-incision laparoscopic total proctocolectomy with ileal pouch anal anastomosis. Colorectal Dis 12:941–943PubMedCrossRef Geisler DP, Condon ET, Remzi FH (2010) Single-incision laparoscopic total proctocolectomy with ileal pouch anal anastomosis. Colorectal Dis 12:941–943PubMedCrossRef
23.
go back to reference Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97:1881–1883PubMedCrossRef Keshava A, Young CJ, Mackenzie S (2010) Single-incision laparoscopic right hemicolectomy. Br J Surg 97:1881–1883PubMedCrossRef
24.
go back to reference Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53:284–288PubMedCrossRef Law WL, Fan JK, Poon JT (2010) Single-incision laparoscopic colectomy: early experience. Dis Colon Rectum 53:284–288PubMedCrossRef
25.
go back to reference Chen WT, Chang SC, Chiang HC, Lo WY, Jeng LB, Wu C, Ke TW (2011) Single-incision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results. Surg Endosc 25:1887–1892PubMedCrossRef Chen WT, Chang SC, Chiang HC, Lo WY, Jeng LB, Wu C, Ke TW (2011) Single-incision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results. Surg Endosc 25:1887–1892PubMedCrossRef
26.
go back to reference Liang JT, Lai HS, Huang KC, Chang KJ, Shieh MJ, Jeng YM, Wang SM (2003) Comparison of medial-to-lateral versus traditional lateral-to-medial dissection sequences for the resection of rectosigmoid cancers: a randomized controlled clinical trial. World J Surg 27:190–196PubMedCrossRef Liang JT, Lai HS, Huang KC, Chang KJ, Shieh MJ, Jeng YM, Wang SM (2003) Comparison of medial-to-lateral versus traditional lateral-to-medial dissection sequences for the resection of rectosigmoid cancers: a randomized controlled clinical trial. World J Surg 27:190–196PubMedCrossRef
27.
go back to reference Liang JT, Lai HS, Lee PH (2007) Laparoscopic medial-to-lateral approach for the curative resection of right-sided colon cancer. Ann Surg Oncol 14:1878–1879PubMedCrossRef Liang JT, Lai HS, Lee PH (2007) Laparoscopic medial-to-lateral approach for the curative resection of right-sided colon cancer. Ann Surg Oncol 14:1878–1879PubMedCrossRef
28.
go back to reference Lee SD, Lim SB (2009) D3 Lymphadenectomy using a medial to lateral approach for curable right-sided colon cancer. Int J Colorectal Dis 24:295–300PubMedCrossRef Lee SD, Lim SB (2009) D3 Lymphadenectomy using a medial to lateral approach for curable right-sided colon cancer. Int J Colorectal Dis 24:295–300PubMedCrossRef
Metadata
Title
Single-incision laparoscopic right colectomy compared with conventional laparoscopy for malignancy: assessment of perioperative and short-term oncologic outcomes
Authors
Jung-A Yun
Seong Hyeon Yun
Yoon Ah Park
Yong Beom Cho
Hee Cheol Kim
Woo Yong Lee
Ho-Kyung Chun
Publication date
01-06-2013
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 6/2013
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2722-5

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