Initial Experience of Single-port Laparoscopic Surgery for Sigmoid Colon Cancer
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Initial Experience of Single-port Laparoscopic Surgery for Sigmoid Colon Cancer Sun Jin Park • Kil Yeon Lee • Byung Mo Kang Sung Il Choi • Suk Hwan Lee
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Published online: 12 December 2012 Ó Socie´te´ Internationale de Chirurgie 2012
Abstract Background Single-port laparoscopic surgery has attracted attention in the field of minimally invasive colorectal surgery. We hypothesized that an experienced laparoscopic surgeon could perform single-port surgery for colon cancer eligible for conventional laparoscopic anterior resection. Our aim was to analyze our initial experience and immediate surgical outcomes of single-port anterior resection. Methods A total of 37 consecutive patients with presumed sigmoid colonic cancer underwent single-port anterior resection with standard laparoscopic instruments between May 2009 and June 2010. Each operation was performed by one of two experienced colorectal surgeons. A cohort of patients who had undergone conventional laparoscopic surgery (CLS) for the same duration a year earlier (August 2007 to September 2008) was used as a historical control. Patient demographics and perioperative outcomes were analyzed and compared with those of CLS.
This study was orally presented at the 10th Asia Pacific Congress of Endoscopic Surgery (ELSA), August 11–13, 2011, Singapore.
Electronic supplementary material The online version of this article (doi:10.1007/s00268-012-1882-8) contains supplementary material, which is available to authorized users. S. J. Park K. Y. Lee (&) B. M. Kang S. I. Choi S. H. Lee Department of Surgery, School of Medicine, Kyung Hee University, Seoul, South Korea e-mail: [email protected] S. J. Park e-mail: [email protected] K. Y. Lee Department of Surgery, Kyung Hee University Hospital, #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, South Korea
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Results There were no significant differences in mean estimated blood loss, mean length of the resection margin, or morbidity between the two groups, but operative time for the single-port group was significantly shorter (118 ± 41 vs 140 ± 42 min; p = 0.017). Single-port laparoscopic surgery was successfully performed in 78.4 % (29/37) of the patients treated in 2010, and CLS was successfully completed in all of the patients treated the previous year (p = 0.000). The main causes of single-port surgery failure were adhesion and tumor location. Conclusions Single-port anterior resection is a feasible and safe procedure with immediate outcomes comparable to those of conventional laparoscopy. Further studies are required to determine the feasibility of single-port surgery for colonic tumors outside the sigmoid colon and the long-term outcome.
Introduction Recent minimally invasive surgery efforts have focused on single-port laparoscopic surgery (SPLS) and natural orifice transluminal endoscopic surgery (NOTES). The NOTES procedure has been successful in both animal models [1, 2] and humans [3], but it is clinically limited and technically challenging. In contrast, SPLS has been clinically applied to appendectomy, cholec
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