Masashi Yamamoto, Keitaro Tanaka, PhD, Shinsuke Masubuchi, PhD, Masatsugu Ishii, PhD, Hiroki Hamamoto, MD, Junji Okuda, PhD, Kazuhisa Uchiyama, PhD. Osaka Medical College
Aims: Laparoscopic right hemicolectomy became the standard of care for treating cecum, ascending and proximal transverse colon cancer in many centers. Most centers use laparoscopic colectomy with extracorporeal resection and anastomosis (LC). Single-incision laparoscopic colectomy with intracorporeal resection and extracorporeal (SC) remains controversial. The aim of the present study is to compare these two techniques using propensity score matching analysis.
Methods: We analysed the data of 111 patients who underwent laparoscopic right hemicolectomy with LC or SC between December 2015 and December 2016. The propensity score was calculated from age, gender, body mass index, the American Society of Anesthesiologists score, previous abdominal surgery and D3 Lymphnode dissection. Short-term outcomes were recorded. Postoperative pain was evaluated using a visual analogue scale (VAS) and postoperative analgesic use as outcome measure.
Results: The length of skin incision in the SC group was significantly shorter than in the LC group: median (range) 3 (3.5-6) cm verses 4 (3-6) cm (P=0.007). The VAS score on day 1 and day 2 after surgery was significantly less in the SC group than in the LC group: median (range) 30 (10-50) verses 50 (20-69) on day 1 (P =0.037) and median (range) 10 (0-50) verses 30 (0-70) on day 2 (P =0.029). Significantly fewer the number of requiring analgesia in the SC group on day 1 and day 2 after surgery: median (range) 1 (0-3) times verses 2 (0-4) times on day 1 (P =0.024) and 1 (0-2) times verses 1 (0-4) times on day 2 (P =0.035). There were no significant differences in operative time, intraoperative blood loss, the number of lymph nodes removed and postoperative courses between the groups.
Conclusions: SC for right colon cancer is safe and technically feasible. SC reduces the length of skin incision and postoperative pain compared with conventional LC.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86771
Program Number: P247
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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