Reduced-port laparoscopic surgery for a tumor-specific mesorectal excision in patients with colorectal cancer: Initial experience with 20 consecutive cases

Sung Uk Bae, Se-Jin Baek, Byung Soh Min, Seung Hyuk Baik, Nam Kyu Kim, Hyuk Hur

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: Single-port plus one-port, reduced-port laparoscopic surgery (RPLS) may decrease collisions between laparoscopic instruments and the camera in a narrow, bony, pelvic cavity while maintaining the cosmetic advantages of single-incision laparoscopic surgery. The aim of this study is to describe our initial experience with and to assess the feasibility and safety of RPLS for tumor-specific mesorectal excisions (TSMEs) in patients with colorectal cancer. Methods: Between May 2010 and August 2012, RPLS for TSME was performed in 20 patients with colorectal cancer. A single port with four channels through an umbilical incision and an additional port in the right lower quadrant were used for RPLS. Results: The median operation time was 231 minutes (range, 160-347 minutes), and the estimated blood loss was 100 mL (range, 50-500 mL). We transected the rectum with one laparoscopic stapler in 17 cases (85%). The median time to soft diet was 4 days (range, 3-6 days), and the length of hospital stay was 7 days (range, 5-45 days). The median total number of lymph nodes harvested was 16 (range, 7-36), and circumferential resection margin involvement was found in 1 case (5%). Seven patients (35%) developed postoperative complications, and no mortalities occurred within 30 days. During the median follow-up period of 20 months (range, 12-40 months), liver metastasis occurred in 1 patient 10 months after surgery, and local recurrence was nonexistent. Conclusion: RPLS for TSME in patients with colorectal cancer is technically feasible and safe without compromising oncologic safety. However, further studies comparing RPLS with a conventional, laparoscopic low-anterior resection are needed to prove the advantages of the RPLS procedure.

Original languageEnglish
Pages (from-to)16-22
Number of pages7
JournalAnnals of Coloproctology
Volume31
Issue number1
DOIs
Publication statusPublished - 2015 Feb 1
Externally publishedYes

Fingerprint

Laparoscopy
Colorectal Neoplasms
Neoplasms
Length of Stay
Safety
Umbilicus
Rectum
Cosmetics
Lymph Nodes
Neoplasm Metastasis
Diet
Recurrence
Mortality
Liver

Keywords

  • Laparoscopy
  • Natural orifice endoscopic surgery
  • Rectal neoplasms

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Reduced-port laparoscopic surgery for a tumor-specific mesorectal excision in patients with colorectal cancer : Initial experience with 20 consecutive cases. / Bae, Sung Uk; Baek, Se-Jin; Min, Byung Soh; Baik, Seung Hyuk; Kim, Nam Kyu; Hur, Hyuk.

In: Annals of Coloproctology, Vol. 31, No. 1, 01.02.2015, p. 16-22.

Research output: Contribution to journalArticle

@article{72a364f0f8f64d888bb33fbf228c6a27,
title = "Reduced-port laparoscopic surgery for a tumor-specific mesorectal excision in patients with colorectal cancer: Initial experience with 20 consecutive cases",
abstract = "Purpose: Single-port plus one-port, reduced-port laparoscopic surgery (RPLS) may decrease collisions between laparoscopic instruments and the camera in a narrow, bony, pelvic cavity while maintaining the cosmetic advantages of single-incision laparoscopic surgery. The aim of this study is to describe our initial experience with and to assess the feasibility and safety of RPLS for tumor-specific mesorectal excisions (TSMEs) in patients with colorectal cancer. Methods: Between May 2010 and August 2012, RPLS for TSME was performed in 20 patients with colorectal cancer. A single port with four channels through an umbilical incision and an additional port in the right lower quadrant were used for RPLS. Results: The median operation time was 231 minutes (range, 160-347 minutes), and the estimated blood loss was 100 mL (range, 50-500 mL). We transected the rectum with one laparoscopic stapler in 17 cases (85{\%}). The median time to soft diet was 4 days (range, 3-6 days), and the length of hospital stay was 7 days (range, 5-45 days). The median total number of lymph nodes harvested was 16 (range, 7-36), and circumferential resection margin involvement was found in 1 case (5{\%}). Seven patients (35{\%}) developed postoperative complications, and no mortalities occurred within 30 days. During the median follow-up period of 20 months (range, 12-40 months), liver metastasis occurred in 1 patient 10 months after surgery, and local recurrence was nonexistent. Conclusion: RPLS for TSME in patients with colorectal cancer is technically feasible and safe without compromising oncologic safety. However, further studies comparing RPLS with a conventional, laparoscopic low-anterior resection are needed to prove the advantages of the RPLS procedure.",
keywords = "Laparoscopy, Natural orifice endoscopic surgery, Rectal neoplasms",
author = "Bae, {Sung Uk} and Se-Jin Baek and Min, {Byung Soh} and Baik, {Seung Hyuk} and Kim, {Nam Kyu} and Hyuk Hur",
year = "2015",
month = "2",
day = "1",
doi = "10.3393/ac.2015.31.1.16",
language = "English",
volume = "31",
pages = "16--22",
journal = "Annals of Coloproctology",
issn = "2287-9714",
publisher = "Korean Society of Coloproctology",
number = "1",

}

TY - JOUR

T1 - Reduced-port laparoscopic surgery for a tumor-specific mesorectal excision in patients with colorectal cancer

T2 - Initial experience with 20 consecutive cases

AU - Bae, Sung Uk

AU - Baek, Se-Jin

AU - Min, Byung Soh

AU - Baik, Seung Hyuk

AU - Kim, Nam Kyu

AU - Hur, Hyuk

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Purpose: Single-port plus one-port, reduced-port laparoscopic surgery (RPLS) may decrease collisions between laparoscopic instruments and the camera in a narrow, bony, pelvic cavity while maintaining the cosmetic advantages of single-incision laparoscopic surgery. The aim of this study is to describe our initial experience with and to assess the feasibility and safety of RPLS for tumor-specific mesorectal excisions (TSMEs) in patients with colorectal cancer. Methods: Between May 2010 and August 2012, RPLS for TSME was performed in 20 patients with colorectal cancer. A single port with four channels through an umbilical incision and an additional port in the right lower quadrant were used for RPLS. Results: The median operation time was 231 minutes (range, 160-347 minutes), and the estimated blood loss was 100 mL (range, 50-500 mL). We transected the rectum with one laparoscopic stapler in 17 cases (85%). The median time to soft diet was 4 days (range, 3-6 days), and the length of hospital stay was 7 days (range, 5-45 days). The median total number of lymph nodes harvested was 16 (range, 7-36), and circumferential resection margin involvement was found in 1 case (5%). Seven patients (35%) developed postoperative complications, and no mortalities occurred within 30 days. During the median follow-up period of 20 months (range, 12-40 months), liver metastasis occurred in 1 patient 10 months after surgery, and local recurrence was nonexistent. Conclusion: RPLS for TSME in patients with colorectal cancer is technically feasible and safe without compromising oncologic safety. However, further studies comparing RPLS with a conventional, laparoscopic low-anterior resection are needed to prove the advantages of the RPLS procedure.

AB - Purpose: Single-port plus one-port, reduced-port laparoscopic surgery (RPLS) may decrease collisions between laparoscopic instruments and the camera in a narrow, bony, pelvic cavity while maintaining the cosmetic advantages of single-incision laparoscopic surgery. The aim of this study is to describe our initial experience with and to assess the feasibility and safety of RPLS for tumor-specific mesorectal excisions (TSMEs) in patients with colorectal cancer. Methods: Between May 2010 and August 2012, RPLS for TSME was performed in 20 patients with colorectal cancer. A single port with four channels through an umbilical incision and an additional port in the right lower quadrant were used for RPLS. Results: The median operation time was 231 minutes (range, 160-347 minutes), and the estimated blood loss was 100 mL (range, 50-500 mL). We transected the rectum with one laparoscopic stapler in 17 cases (85%). The median time to soft diet was 4 days (range, 3-6 days), and the length of hospital stay was 7 days (range, 5-45 days). The median total number of lymph nodes harvested was 16 (range, 7-36), and circumferential resection margin involvement was found in 1 case (5%). Seven patients (35%) developed postoperative complications, and no mortalities occurred within 30 days. During the median follow-up period of 20 months (range, 12-40 months), liver metastasis occurred in 1 patient 10 months after surgery, and local recurrence was nonexistent. Conclusion: RPLS for TSME in patients with colorectal cancer is technically feasible and safe without compromising oncologic safety. However, further studies comparing RPLS with a conventional, laparoscopic low-anterior resection are needed to prove the advantages of the RPLS procedure.

KW - Laparoscopy

KW - Natural orifice endoscopic surgery

KW - Rectal neoplasms

UR - http://www.scopus.com/inward/record.url?scp=84925860400&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925860400&partnerID=8YFLogxK

U2 - 10.3393/ac.2015.31.1.16

DO - 10.3393/ac.2015.31.1.16

M3 - Article

AN - SCOPUS:84925860400

VL - 31

SP - 16

EP - 22

JO - Annals of Coloproctology

JF - Annals of Coloproctology

SN - 2287-9714

IS - 1

ER -