Objective To assess feasibility and safety of single-incision plus one laparoscopic surgery (SILS+1) in radical treatment of rectal cancer combined with analysis of short-term clinical and oncological outcomes. Methods Clinical data were studied retrospectively with 20 patients who underwent radical rectal cancer resection through SILS+1 from September 2013 to January 2018 in our department. A propensity score matching approach was used on pooled the data of 62 cases with single-incision laparoscopic surgery of rectal cancer at a radio of 1∶1 as control group of 20 cases after matching the demographic information of the patients and body mass index, American Society of Anesthesiologists score (≤2/>2) and TNM (0-Ⅰ/Ⅱ/Ⅲ) stage. Clinical data and operative results were analyzed between SILS+1 group and control group. Results No significant differences were observed in operative time, blood loss, tumor size, retrieved lymph node, length of incision, postoperative hospital stay between SILS+1 group and control group. However, SILS+1 group showed significantly shorter distance of rectal cancer from the anal verge (P<0.05). The median follow-up period was 24.5 months in SILS+1 group and 26.5 months in control group. There was no recurrent case in both groups. Conclusions SILS+1 for rectal cancer is feasible and safe, and can be used to treat rectal cancer more near from the anal verge.
LI Jun, LI You, SHI Yiqing, LIU Kun, JIANG Yimei, SONG Zijia, ZHAO Ren
. Single-incision plus one laparoscopic surgery in treatment of rectal cancer: a preliminary study[J]. Journal of Surgery Concepts & Practice, 2019
, 24(01)
: 65
-69
.
DOI: 10.16139/j.1007-9610.2019.01.014
[1] Bucher P, Pugin F, Morel P.Single port access laparoscopic right hemicolectomy[J]. Colorectal Dis,2008,23(10):1013-1016.
[2] Remzi FH, Kirat HT, Kaouk JH, et al.Single-port laparoscopy in colorectal surgery[J]. Colorectal Dis,2008,10(8):823-826.
[3] Bucher P, Pugin F, Morel P.Transumbilical single incision laparoscopic sigmoidectomy for benign disease[J]. Colorectal Dis,2010,12(1):61-65.
[4] Hirano Y, Hattori M, Douden K, et al. Single-incision laparoscopic surgery for colorectal cancer[J]. World J Gastrointest Surg,2016,27:8(1):95-100.
[5] Hirano Y, Hattori M, Douden K, et al.Single-incision plus one port laparoscopic anterior resection for rectal cancer as a reduced port surgery[J]. Scand J Surg,2012, 101(4):283-286.
[6] 李佑, 蒋奕玫, 刘坤, 等. 经脐单孔腹腔镜技术在治疗乙状结肠癌中应用的探索性经验[J]. 外科理论与实践,2016,21(6):483-487.
[7] Ragupathi M, Ramos-Valadez DI, Yaakovian MD, et al.Single-incision laparoscopic colectomy: a novel approach through a Pfannenstiel incision[J]. Tech Coloproctol,2011, 15(1):61-65.
[8] Mettler L, Nikam YA.A comparative survey of various uterine manipulators used in operative laparoscopy[J]. Gynecol Surg,2006,3(4):239-243.
[9] Bulut O, Nielsen CB.Single-incision laparoscopic low anterior resection for rectal cancer[J]. Int J Colorectal Dis,2010,25(10):1261-1263.
[10] Uematsu D, Akiyama G, Magishi A, et al.Single-access laparoscopic left and right hemicolectomy combined with extracorporeal magnetic retraction[J]. Dis Colon Rectum,2010,53(6):944-948.
[11] Huscher CG, Mingoli A, Sgarzini G, et al.Standard laparoscopic versus single-incision laparoscopic colectomy for cancer: early results of a randomized prospective study[J]. Am J Surg,2012,204(1):115-120.
[12] Poon JT, Cheung CW, Fan JK, et al.Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized controlled trial[J]. Surg Endosc,2012,26(10):2729-2734.
[13] Watanabe J, Ota M, Fujii S, et al.Randomized clinical trial of single-incision versus multiport laparoscopic colectomy[J]. Br J Surg,2016,103(10):1276-1281.
[14] Kang BM, Park SJ, Lee KY, et al.Single-port laparoscopic surgery can be performed safely and appropriately for colon cancer: short-term results of a pilot randomized controlled trial[J]. J Laparoendosc Adv Surg Tech A,2017,27(5):501-509.
[15] Kim JS, Cho SY, Min BS, et al.Risk factors for anastomotic leakage after laparoscopic intracorporeal colorectal anastomosis with a double stapling technique[J]. Am Coll Surg,2009,209(6):694-701.
