Sang Woo Lim, MD PhD, Jung Wook Huh, MD, Young Jin Kim, MD PhD, Hyeong Rok Kim, MD PhD. Department of Colon and Rectal Surgery, Chonnam National University Hwasun Hospital, Gwangju, Korea
This randomized clinical trial compared the minilaparotomy of transumblical incision (UMB) via which specimen was delivered extracorporeally with left lower transverse incision (LLT) in laparoscopic anterior or low anterior resection with colorectal cancer.
METHODS AND PROCEDURES:
Patient scheduled for laparoscopic colectomy for sigmoid and rectal cancer were randomly classified according to the site of minilaparotomy as two groups of UMB and LLT. Surgical outcomes including incision length of minilaparotomy were assessed. Postoperative pain was measured using a visual analogue pain score.
The study included 136 consecutive patients (81 UMB, 55 LLT), 60 of whom underwent anterior resection and 76 low anterior resection. Demographic datas including American Society of Anesthesiologists grade, Body Mass Index(kg/m²), and operation times were similar in the two groups. Postoperative pain scores were similar between UMB and LLT at 6hour(mean, 2.6 versus 2.5, p=0.760), 12hour (mean, 2.1 versus 1.2, p=0.085), 24hour(mean, 2.0 versus 1.3, p=0.081), 48hour(mean, 1.9 versus 1.4, p=0.236) and 5day(mean, 1.7 versus 1.1, p=0.178).
The length of minilaparotomy was shorter in UMB than LLT (mean, 4.7 cm versus 5.8 cm, p=0.000). The early wound related complication of surgical-site infection was 12 cases in UMB, and 7 cases in LLT(p=0.863). Hospital stay was similar in the two groups.
The transumblical minilaparotomy in laparoscopic colorectal surgery is a feasible approach with possible benefits such as better cosmetic outcomes.
Program Number: P152