Jin Yong Shin, PhD, Hyeon Yu, MD. Department of Surgery, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea.
Currently, laparoscopic colectomy for colon cancer is performed with reducing the number of ports by experienced laparoscopic surgeons. However, single-port laparoscopic colectomy (SPLC) for colon cancer is a challenging procedure because of technical difficulties such as the handling of laparoscopic instruments and triangulation of surgical plane. To overcoming the technical challenges of SPLC, only few studies reported the feasibility and safety of reduced port laparoscopic colectomy (RPLC) for colon cancer. The purpose of this study is to evaluate the feasibility and safety of RPLC for colon cancer by comparison with multi-port laparoscopic colectomy (MPLC) and SPLC.
\Totally 170 patients with minimally invasive colectomy for colon cancer between July 2010 and June 2013 were included in this study, 40 patients were treated by SPLC, 38 patients by RPLC and 92 patients by MPLC. Perioperative variables and short-term surgical outcomes, including operative time, pathological data and complication rate, were analyzed between three groups.
The mean operating time for RPLC, SPLC and MPLC group were significantly different. (216.2±53.7, 207.2±49.6 and 243.5±59.0 minutes, respectively, p=0.001). The number of harvested lymph node was significantly higher in RPLC group compared with the SPLC and MPLC group (29.9±21.5, 24.2±13.8 and 21.9±12.1, respectively, p=0.027). The comparison of the time to first flatus between three groups (RPLC, SPLC and MPLC) showed the statistical difference (3.4±1.1 days, 3.6±1.3 days and. 3.1±1.2 days, respectively, p=0.039). No difference was found in postoperative pain scores, postoperative hospital stays and complication rate among three groups (p=0.187).
Considering favorable short-term outcomes of RPLC for colon cancer regarding the operative time and the number of harvested lymph node in this study, RPLC for colon cancer seems to feasible, safe and may be considered a surgical option in minimally invasive colectomy for colon cancer.