Single Port Laparoscopic Colectomy: Long Term Outcome

Ovunc Bardakcioglu, MD FACS. Saint Louis University

INTRODUCTION: Single port laparoscopic colectomy is described as a new technique in colorectal surgery. These initial case reports and series show the feasibility and short term outcome only. We report our long term outcome for the initial 20 single port laparoscopic right hemicolectomies without selection bias.

METHODS: Between July 2009 and September 2010 20 patients with the indication for a right hemicolectomy underwent a single port laparoscopic approach without selection bias. The only exclusion criterium was a prior midline laparotomy. The patients were followed for a median of 24 months (range 12 to 33 months).

RESULTS: The median age was 65 (range 59 to 88). 90% of patients were male. The median BMI was 28 (range 20 to 35). 75% of patients had significant co-morbidities with an ASA class of 3 and 4. The estimated blood loss was 25cc (range 25 to 250). The median number of pathologic lymph nodes for patients diagnosed with adenocarcinoma was 16 (range 8 to 23). There was one conversion to hand-assisted laparoscopic (case 6) and one to open colectomy (case 9) due to the inability of safe vessel ligation. The median hospital stay was 4.5 days (range 3 to 7).. The mean operative time for the first 10 cases was 198 min (range 148 to 272) and for the following 10 cases 123 min (range 98 to 150 min). There were no significant postoperative complications within 30 days.

At a median follow up of 24 months there were no patients with local recurrence or distant metastases. One patient died 17 months after resection from a myocardial infarction. Two patients developed an incisional hernia with one requiring a laparoscopic incisional hernia repair.

CONCLUSION(S): Single port laparoscopic right hemicolectomy can be safely performed for patients who were candidates for conventional laparoscopic right hemicolectomy with a very low postoperative complication rate and comparable long term outcome.

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