BACKGROUND: Laparoscopic colectomy has been shown to confer equivalent disease-free and overall survival compared to traditional open colectomy. Patients experience benefit in length of hospital stay as well as diminished narcotic use. Single-incision laparoscopic colectomy (SIL-C) may offer additional benefit compared to traditional laparoscopic colectomy without compromising oncologic principles. METHODS: We retrospectively reviewed records of patients who underwent SIL-C and traditional laparoscopic colectomy (TLC) for potentially malignant and malignant disease performed by a single surgeon. SIL-C consisted of a single-port access device with traditional lateral-to-medial laparoscopic technique. RESULTS: Between January and October 2009, 27 SIL-C procedures were performed. Forty-six TLC patients from the prior year were used as controls. Median age was 70 years and 54% were female, with no differences between the groups. The median body mass index (BMI) was 27 kg/m(2) (range = 18.3-39.9) and 26 kg/m(2) (16.6-71.4) for SIL-C and TLC, respectively. The median lymph node harvest was 15 (range = 3-32) and 17 (0-35) for SIL-C and TLC, respectively. The median operative time was 114 min (range = 59-268) and 135 min (45-314) for SIL-C and TLC, respectively. Five SIL-C required additional ports while six TLC required conversion to open technique. The median length of stay was 3 days (range = 2-17) and 5 days (range = 2-11) for SIL-C and TLC, respectively (p = 0.079). There were five significant postoperative complications in the SIL-C group and 16 in the TLC group, including four postoperative ileus and one leak. There were no postoperative deaths in the SIL-C group and two in the TLC group. CONCLUSIONS: SIL-C can be used safely in selected colon cancer patients with no difference in blood loss, OR time, or lymph node retrieval. SIL-C patients may have a shorter LOS.
BACKGROUND: Laparoscopic colectomy has been shown to confer equivalent disease-free and overall survival compared to traditional open colectomy. Patients experience benefit in length of hospital stay as well as diminished narcotic use. Single-incision laparoscopic colectomy (SIL-C) may offer additional benefit compared to traditional laparoscopic colectomy without compromising oncologic principles. METHODS: We retrospectively reviewed records of patients who underwent SIL-C and traditional laparoscopic colectomy (TLC) for potentially malignant and malignant disease performed by a single surgeon. SIL-C consisted of a single-port access device with traditional lateral-to-medial laparoscopic technique. RESULTS: Between January and October 2009, 27 SIL-C procedures were performed. Forty-six TLCpatients from the prior year were used as controls. Median age was 70 years and 54% were female, with no differences between the groups. The median body mass index (BMI) was 27 kg/m(2) (range = 18.3-39.9) and 26 kg/m(2) (16.6-71.4) for SIL-C and TLC, respectively. The median lymph node harvest was 15 (range = 3-32) and 17 (0-35) for SIL-C and TLC, respectively. The median operative time was 114 min (range = 59-268) and 135 min (45-314) for SIL-C and TLC, respectively. Five SIL-C required additional ports while six TLC required conversion to open technique. The median length of stay was 3 days (range = 2-17) and 5 days (range = 2-11) for SIL-C and TLC, respectively (p = 0.079). There were five significant postoperative complications in the SIL-C group and 16 in the TLC group, including four postoperative ileus and one leak. There were no postoperative deaths in the SIL-C group and two in the TLC group. CONCLUSIONS:SIL-C can be used safely in selected colon cancerpatients with no difference in blood loss, OR time, or lymph node retrieval. SIL-Cpatients may have a shorter LOS.
Authors: Pierre J Guillou; Philip Quirke; Helen Thorpe; Joanne Walker; David G Jayne; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: Lancet Date: 2005 May 14-20 Impact factor: 79.321
Authors: Mark Buunen; Ruben Veldkamp; Wim C J Hop; Esther Kuhry; Johannes Jeekel; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio Lacy; Hendrik J Bonjer Journal: Lancet Oncol Date: 2008-12-13 Impact factor: 41.316
Authors: Heidi Nelson; Daniel J Sargent; H Sam Wieand; James Fleshman; Mehran Anvari; Steven J Stryker; Robert W Beart; Michael Hellinger; Richard Flanagan; Walter Peters; David Ota Journal: N Engl J Med Date: 2004-05-13 Impact factor: 91.245
Authors: Karl Y Bilimoria; David J Bentrem; Ryan P Merkow; Heidi Nelson; Edward Wang; Clifford Y Ko; Nathaniel J Soper Journal: J Gastrointest Surg Date: 2008-06-24 Impact factor: 3.452