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Oncological and clinical safety of single-incision laparoscopic surgery for colon cancer with previous abdominal surgery: a propensity score-matched comparison.

Yasumitsu Hirano1, Chikashi Hiranuma, MD, PhD2, Masakazu Hattori2, Kenji Douden2, Shigeki Yamaguchi1. 1Saitama Medical University International Medical Center, 2Fukui Prefectural Hospital

Introduction: Previous abdominal surgery (PAS) may affect the operative time and intra-operative bowel injury, and can also influence the postoperative complications including postoperative bowel obstruction and paralytic ileus. At the beginning of laparoscopic experience, PAS was even considered contraindications for this approach. However, the advances in laparoscopic surgery, the indications for laparoscopy was extended to patients with PAS without adverse consequences on outcome. In this study, we evaluated the outcome of SILC in locally advanced colon cancer patients with PAS with a propensity score matched comparison to assess its perioperative and long-term oncological outcomes.

Methods: 68 locally advanced colon cancer patients with PAS who electively underwent SILC were included in this study. 68 patients were then chosen out of a collective of 118 patients without PAS in a propensity score matched design. Short-term clinical outcomes in both groups were compared, and verified its long-term oncological outcome.

Results: In the patients with PAS, the mean skin incision length was 2.91 cm, and the median estimated blood loss and median operating time were 27.9 mL and 180.0 min, respectively. The mean number of harvested lymph nodes was 27.6. There were not significant differences in all these variables between two groups. There were no 30-days mortalities in both groups. Postoperative complications were occurred 7 cases (10.3%) in each group, and the rate was not significantly different. There were also no significant differences in postoperative hospital stay between both two groups (15.1 vs 10.5 days; p=0.091). There were 10 occurrences of tumor recurrence or metastasis (14.7%) in 68 patients with the median follow-up 55 months in patients with PAS. The 5-year relapse-free survival rates were 71.0% in patients with PAS and 76.0% in patients without PAS, respectively, and the 5-year overall survival rates were 75.4% with PAS and 88.9% without PAS, respectively. No significant differences were revealed between both groups (RFS; p=0.69, OS; p=0.117).

Conclusions: Our initial experiences may suggest that long-term oncological and clinical safety of SILC for colon cancer patients with previous abdominal surgery. However, further studies need to be undertaken to prove its superiority to conventional laparoscopic surgery in colon cancer patients with previous abdominal surgery.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 94070

Program Number: P346

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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