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Reduced-Port Laparoscopic Surgery for a Tumor-Specific Mesorectal Excision in Patients With Colorectal Cancer: Initial Experience With 20 Consecutive Cases

Authors
 Sung Uk Bae  ;  Se Jin Baek  ;  Byung Soh Min  ;  Seung Hyuk Baik  ;  Nam Kyu Kim  ;  Hyuk Hur 
Citation
 Annals of Coloproctology, Vol.31(1) : 16-22, 2015 
Journal Title
 Annals of Coloproctology 
ISSN
 2287-9714 
Issue Date
2015
Keywords
Laparoscopy ; Natural orifice endoscopic surgery ; Rectal neoplasms
Abstract
PURPOSE: Single-port plus one-port, reduced-port laparoscopic surgery (RPLS) may decrease collisions between laparoscopic instruments and the camera in a narrow, bony, pelvic cavity while maintaining the cosmetic advantages of single-incision laparoscopic surgery. The aim of this study is to describe our initial experience with and to assess the feasibility and safety of RPLS for tumor-specific mesorectal excisions (TSMEs) in patients with colorectal cancer. METHODS: Between May 2010 and August 2012, RPLS for TSME was performed in 20 patients with colorectal cancer. A single port with four channels through an umbilical incision and an additional port in the right lower quadrant were used for RPLS. RESULTS: The median operation time was 231 minutes (range, 160-347 minutes), and the estimated blood loss was 100 mL (range, 50-500 mL). We transected the rectum with one laparoscopic stapler in 17 cases (85%). The median time to soft diet was 4 days (range, 3-6 days), and the length of hospital stay was 7 days (range, 5-45 days). The median total number of lymph nodes harvested was 16 (range, 7-36), and circumferential resection margin involvement was found in 1 case (5%). Seven patients (35%) developed postoperative complications, and no mortalities occurred within 30 days. During the median follow-up period of 20 months (range, 12-40 months), liver metastasis occurred in 1 patient 10 months after surgery, and local recurrence was nonexistent. CONCLUSION: RPLS for TSME in patients with colorectal cancer is technically feasible and safe without compromising oncologic safety. However, further studies comparing RPLS with a conventional, laparoscopic low-anterior resection are needed to prove the advantages of the RPLS procedure.
Files in This Item:
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DOI
10.3393/ac.2015.31.1.16
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
Yonsei Authors
김남규(Kim, Nam Kyu) ORCID logo https://orcid.org/0000-0003-0639-5632
민병소(Min, Byung Soh)
배성욱(Bae, Sung Uk)
백승혁(Baik, Seung Hyuk)
허혁(Hur, Hyuk) ORCID logo https://orcid.org/0000-0002-9864-7229
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165661
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