Laparoscopic complete mesocolic excision conducted by reduced port surgery for colon cancer

Shinichiro Mori, MD, Yoshiaki Kita, MD, Kenji Baba, MD, Shigehiro Yanakita, MD, Kosei Maemura, MD, Hiroshi Okumura, MD, Tetsuhiro Nakajyo, Shoji Natsugoe, MD

Department of Digestive Surgery, Breast and Thyroid Surgery Graduate School of Medical and Dental Sciences

This study aimed to report our experience and technical strategies with 7 patients who were treated with laparoscopic complete mesocolic excision (CME) conducted by reduced port surgery (RPS) for colon cancer.

This is a retrospective analysis of prospectively gathered data for 7 consecutive patients with colon cancer who underwent laparoscopic CME conducted medial to lateral access by RPS using GelPOINT through an umbilical zigzag skin incision. The quality of surgery was assessed by reviewing the recorded video obtained through the operations and evaluated in terms of operative data, completion of CME, cosmesis, complications, hospitalization, and histopathological data.

Between February 2012 and August 2012, 7 consecutive patients underwent laparoscopic colectomy by RPS for colon cancer. The medial to lateral access with en bloc resection of enveloped parietal planes was completed for all patients. These cases were evaluated as good plane without defections to the planes. The median operation time was 290 min and blood loss was 40ml. The median number of lymph nodes retrieved was 19.4 (range, 9-30) and lymph nodes metastasis was found in four of all cases. The median length of umbilical skin incision was 4.3 (range, 4-5) cm, which shrink in 3.1 (range, 2.5-3.5) cm after surgery. No intraoperative complications were observed in this series. Postoperatively, there were no complications and mortality. The median time for hospitalization was 14 days.

Laparoscopic CME conducted by RPS through an umbilical zigzag skin incision is a novel technical strategy with advantage to cosmesis for colon cancer surgery. Our experience suggests this technical strategy for laparoscopic colectomy is acceptable, however, randomized trial are needed to evaluate its short and long-term outcomes.

Session: Poster Presentation

Program Number: P056

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