Single-incision Plus One Port Versus Standard Multiport Laparoscopic Surgery for Rectal Cancer
Keywords:
Single incision laparoscopic surgery, rectal cancer, colorectal surgeryAbstract
We reported the preliminary results of the comparison of perioperative outcomes between single-incision plusone port laparoscopic rectal resection (SILS+1) and standard multiport laparoscopic rectal resection (MPL) at Hatyai
Hospital.
Materials and Methods: The data were retrospectively collected for patients undergoing SILS+1 (34 patients),
and MPL (30 patients) at Hatyai Hospital from January 2011 to September 2013. The demographic data, operative time,
hospital stay, postoperative pain, conversion to open surgery, and postoperative complications were analyzed.
Results: With the exception of more males in the SILS+1 group, demographic data were similar in both groups.
Most of the procedures were low anterior resection in both groups (28/34 in SILS+1 and 26/30 in MPL). The operative
time was longer in the MPL group (p = 0.01). There were no significant differences in mean estimated blood loss (282.2
mL vs. 208.0 mL), number of open conversions (1 vs. 3), mean maximum postoperative pain score (6.1 vs. 7.3), mean
hospital stay (13.4 days vs. 10.9 days), number of reoperations (1 vs. 2) and complication rate (5.9% vs. 13.3%). Average
length of specimen was longer in the SILS+1 group (19.7 cm vs. 16.2 cm, p = 0.01), which also had more advanced stage
tumors (p = 0.01). There were no significant differences in mean tumor size (4.8 cm vs. 4.1 cm), mean distal margin
(2.2 cm vs. 2.4 cm) and mean number of harvested lymph nodes (10 vs. 9) between the two groups.
Conclusion: Preliminary results of the present study showed that SILS+1 is safe and has similar perioperative
outcomes as MPL.
References
1. Kuhry E, Schwenk W, Gaupset R, Romild U, BonjerJ. Long-term
outcome of laparoscopic surgery for colorectal cancer: a
Cochrane systematic review of randomised controlled trials.
Cancer Treat Rev 2008;34:498-504.
2. Liang Y, Li G, Chen P, Yu J. Laparoscopic versus open colorectal
resection for cancer: a meta-analysis of results of randomized
controlled trials on recurrence. Eur J SurgOncol 2008;34:1217-
24.
3. Watanabe M. Laparoscopic anterior resection for rectal
cancer. In: Milsom JW, BohmB, Nakajima K, editors.
Laparoscopic colorectal surgery. 2nd ed. New York: Springer;
2006. p. 170-187.
4. Chadwick M, Gudgeon M. Basic laparoscopic colorectal
surgery. Surgery 2011;29:21-8.
5. Fujii S, Watanabe K, Ota M, et al. Single-incision laparoscopic
surgery using colon-lifting technique for colorectal cancer: a
matched case-control comparison with standard multiport
laparoscopic surgery in terms of short-term results and access
instrument cost. Surg Endosc 2012;26:1403-11.
6. Uematsu D, Akiyama G, Narita M, Magishi A. Single-access
laparoscopic low anterior resection with vertical suspension
of the rectum. Dis Colon Rectum 2011;54:632-7.
7. Khuhaprema T, SrivatanakulP. Colon and rectum cancer in
Thailand: an overview. Jpn J Clin Oncol 2008;38:237-43.
8. Prechawittayakul P. [Internet].Songkhla: Songklanagarind
Hospital; 2013 [cited 2013,12,20]. Hospital-based cancer registry.
Songklanagarind Hospital annual report 2011.
Available from:http://medinfo2.psu.ac.th/cancer
9. Poon JT, Law WL. Laparoscopic resection for rectal cancer: a
review. Ann SurgOncol 2009;16:3038-47.
10. Fürst A, Schwandner O, Heiligensetzer A, Iesalnieks I, Agha A.
Laparoscopic TME in rectal cancer-electronic supplementary:
op-video. Langenbecks Arch Surg 2010;395:181-3.
11. FleshmanJW. Laparoscopic colon and rectal surgery. In:
Cameron JL, Cameron AM. Current surgical therapy. 11th ed.
Philadelphia: Elsevier; 2014. p. 1369-77.
12. Makino T, Milsom JW, Lee SW. Feasibility and safety of singleincision
laparoscopic colectomy: a systematic review. Ann
Surg 2012;255:667-76.
13. Pedraza R, Aminian A, Nieto J, Faraj C, Pickron TB, Haas EM.
Single-incision laparoscopic colectomy for cancer: short-term
outcomes and comparative analysis. Minim Invasive Surg
2013 doi: 10.1155/2013/283438. PMID23766897.
14. Makino T, Milsom JW, Lee SW. Single-incision laparoscopic
surgeries for colorectal diseases: early experiences of a novel
surgical method. Minim Invasive Surg. 2012 doi: 10.1155/2012/
783074. PMID22888419.
15. Khaimook A, Borkird J. A preliminary report on laparoscopic
surgery for colorectal cancer in middle-sized secondary
hospitals. Songkla Med J 2008;26:291-7.
16. Khaimook A. Single-incision versus conventional multipleincision
laparoscopic cholecystectomy at Hat Yai Hospital. J
Med Assoc Thai 2012;95:771-4.
17. Law WL, Lee YM, Choi HK, Seto CL, Ho JW. Laparoscopic and
open anterior resection for upper and mid rectal cancer: an
evaluation of outcomes. Dis Colon Rectum 2006; 49:1108-15.
18. Ng SS, Leung KL, Lee JF, et al. Laparoscopic-assisted versus
open abdominoperineal resection for low rectal cancer: a
prospective randomized trial. Ann Surg Oncol 2008;15:2418-
25.
19. Hirano Y, Hattori M, Douden K, et al. Single-incision plus one
port laparoscopic anterior resection for rectal cancer as a
reduced port surgery. Scand J Surg 2012;101:283-6.
20. Ng SS, Lee JF, Yiu RY, et al. Laparoscopic-assisted versus open
total mesorectal excision with anal sphincter preservation for
mid and low rectal cancer: a prospective, randomized trial.
Surg Endosc 2014;28:297-306.
21. Bulut O, Aslak KK, RosenstockS. Technique and short-term
outcomes of single-port surgery for rectal cancer: A feasibility
study of 25 patients. Scand J Surg 2013;1-8.
22. Sirikurnpiboon S, Jivapaisarnpong P. Single-access
laparoscopic rectal surgery is technically feasible. Minim
Invasive Surg 2013 doi:10.1155/2013/687134. PMID23577248.
23. Lim SW, Kim HJ, Kim CH, Huh JW, Kim YJ, Kim HR. Umbilical
incision laparoscopic colectomy with one additional port for
colorectal cancer. Tech Coloproctol 2013;17:193-9.
24. Kim SH, Park IJ, Joh YG, Hahn KY. Laparoscopic resection for
rectal cancer: a prospective analysis of thirty-month followup
outcomes in 312 patients. Surg Endosc 2006;20:1197-202.
25. Kim SH, Park IJ, Joh YG, Hahn KY. Laparoscopic resection of
rectal cancer: a comparison of surgical and oncologic
outcomes between extraperitoneal and intraperitoneal
disease locations. Dis Colon Rectum 2008;51:844-51.
26. Champagne BJ, Papaconstantinou HT, Parmar SS, et al. Singleincision
versus standard multiport laparoscopic colectomy: a
multicenter, case-controlled comparison. Ann Surg 2012;
255:66-9.
27. Fung AK, AlyEH. Systematic review of single-incision
laparoscopic colonic surgery. Br J Surg 2012;99:1353-64.
28. Wu WX, Sun YM, Hua YB, ShenLZ. Laparoscopic versus
conventional open resection of rectal carcinoma: A clinical
comparative study. World J Gastroenterol 2004;10:1167-70.
29. Alptekin H, Yilmaz H, Acar F, Kafali ME, SahinM.Incisional
hernia rate may increase after single-port cholecystectomy.
J Laparoendosc Adv Surg Tech 2012;22(8):731-7.
30. Samia H, Lawrence J, Nobel T, Stein S, Champagne BJ,
Delaney CP.Extraction site location and incisional hernias
after laparoscopic colorectal surgery: should we be avoiding
the midline? Am J Surg 2013; 205(3):264-8.
outcome of laparoscopic surgery for colorectal cancer: a
Cochrane systematic review of randomised controlled trials.
Cancer Treat Rev 2008;34:498-504.
2. Liang Y, Li G, Chen P, Yu J. Laparoscopic versus open colorectal
resection for cancer: a meta-analysis of results of randomized
controlled trials on recurrence. Eur J SurgOncol 2008;34:1217-
24.
3. Watanabe M. Laparoscopic anterior resection for rectal
cancer. In: Milsom JW, BohmB, Nakajima K, editors.
Laparoscopic colorectal surgery. 2nd ed. New York: Springer;
2006. p. 170-187.
4. Chadwick M, Gudgeon M. Basic laparoscopic colorectal
surgery. Surgery 2011;29:21-8.
5. Fujii S, Watanabe K, Ota M, et al. Single-incision laparoscopic
surgery using colon-lifting technique for colorectal cancer: a
matched case-control comparison with standard multiport
laparoscopic surgery in terms of short-term results and access
instrument cost. Surg Endosc 2012;26:1403-11.
6. Uematsu D, Akiyama G, Narita M, Magishi A. Single-access
laparoscopic low anterior resection with vertical suspension
of the rectum. Dis Colon Rectum 2011;54:632-7.
7. Khuhaprema T, SrivatanakulP. Colon and rectum cancer in
Thailand: an overview. Jpn J Clin Oncol 2008;38:237-43.
8. Prechawittayakul P. [Internet].Songkhla: Songklanagarind
Hospital; 2013 [cited 2013,12,20]. Hospital-based cancer registry.
Songklanagarind Hospital annual report 2011.
Available from:http://medinfo2.psu.ac.th/cancer
9. Poon JT, Law WL. Laparoscopic resection for rectal cancer: a
review. Ann SurgOncol 2009;16:3038-47.
10. Fürst A, Schwandner O, Heiligensetzer A, Iesalnieks I, Agha A.
Laparoscopic TME in rectal cancer-electronic supplementary:
op-video. Langenbecks Arch Surg 2010;395:181-3.
11. FleshmanJW. Laparoscopic colon and rectal surgery. In:
Cameron JL, Cameron AM. Current surgical therapy. 11th ed.
Philadelphia: Elsevier; 2014. p. 1369-77.
12. Makino T, Milsom JW, Lee SW. Feasibility and safety of singleincision
laparoscopic colectomy: a systematic review. Ann
Surg 2012;255:667-76.
13. Pedraza R, Aminian A, Nieto J, Faraj C, Pickron TB, Haas EM.
Single-incision laparoscopic colectomy for cancer: short-term
outcomes and comparative analysis. Minim Invasive Surg
2013 doi: 10.1155/2013/283438. PMID23766897.
14. Makino T, Milsom JW, Lee SW. Single-incision laparoscopic
surgeries for colorectal diseases: early experiences of a novel
surgical method. Minim Invasive Surg. 2012 doi: 10.1155/2012/
783074. PMID22888419.
15. Khaimook A, Borkird J. A preliminary report on laparoscopic
surgery for colorectal cancer in middle-sized secondary
hospitals. Songkla Med J 2008;26:291-7.
16. Khaimook A. Single-incision versus conventional multipleincision
laparoscopic cholecystectomy at Hat Yai Hospital. J
Med Assoc Thai 2012;95:771-4.
17. Law WL, Lee YM, Choi HK, Seto CL, Ho JW. Laparoscopic and
open anterior resection for upper and mid rectal cancer: an
evaluation of outcomes. Dis Colon Rectum 2006; 49:1108-15.
18. Ng SS, Leung KL, Lee JF, et al. Laparoscopic-assisted versus
open abdominoperineal resection for low rectal cancer: a
prospective randomized trial. Ann Surg Oncol 2008;15:2418-
25.
19. Hirano Y, Hattori M, Douden K, et al. Single-incision plus one
port laparoscopic anterior resection for rectal cancer as a
reduced port surgery. Scand J Surg 2012;101:283-6.
20. Ng SS, Lee JF, Yiu RY, et al. Laparoscopic-assisted versus open
total mesorectal excision with anal sphincter preservation for
mid and low rectal cancer: a prospective, randomized trial.
Surg Endosc 2014;28:297-306.
21. Bulut O, Aslak KK, RosenstockS. Technique and short-term
outcomes of single-port surgery for rectal cancer: A feasibility
study of 25 patients. Scand J Surg 2013;1-8.
22. Sirikurnpiboon S, Jivapaisarnpong P. Single-access
laparoscopic rectal surgery is technically feasible. Minim
Invasive Surg 2013 doi:10.1155/2013/687134. PMID23577248.
23. Lim SW, Kim HJ, Kim CH, Huh JW, Kim YJ, Kim HR. Umbilical
incision laparoscopic colectomy with one additional port for
colorectal cancer. Tech Coloproctol 2013;17:193-9.
24. Kim SH, Park IJ, Joh YG, Hahn KY. Laparoscopic resection for
rectal cancer: a prospective analysis of thirty-month followup
outcomes in 312 patients. Surg Endosc 2006;20:1197-202.
25. Kim SH, Park IJ, Joh YG, Hahn KY. Laparoscopic resection of
rectal cancer: a comparison of surgical and oncologic
outcomes between extraperitoneal and intraperitoneal
disease locations. Dis Colon Rectum 2008;51:844-51.
26. Champagne BJ, Papaconstantinou HT, Parmar SS, et al. Singleincision
versus standard multiport laparoscopic colectomy: a
multicenter, case-controlled comparison. Ann Surg 2012;
255:66-9.
27. Fung AK, AlyEH. Systematic review of single-incision
laparoscopic colonic surgery. Br J Surg 2012;99:1353-64.
28. Wu WX, Sun YM, Hua YB, ShenLZ. Laparoscopic versus
conventional open resection of rectal carcinoma: A clinical
comparative study. World J Gastroenterol 2004;10:1167-70.
29. Alptekin H, Yilmaz H, Acar F, Kafali ME, SahinM.Incisional
hernia rate may increase after single-port cholecystectomy.
J Laparoendosc Adv Surg Tech 2012;22(8):731-7.
30. Samia H, Lawrence J, Nobel T, Stein S, Champagne BJ,
Delaney CP.Extraction site location and incisional hernias
after laparoscopic colorectal surgery: should we be avoiding
the midline? Am J Surg 2013; 205(3):264-8.
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Published
2014-03-31
How to Cite
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Alapach S, Khaimook A, Chomvilailuk M. Single-incision Plus One Port Versus Standard Multiport Laparoscopic Surgery for Rectal Cancer. Thai J Surg [Internet]. 2014 Mar. 31 [cited 2024 Nov. 22];35(1). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/226374
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