Single-incision laparoscopic colectomy for malignant disease

Megan E. McNally, B. Todd Moore, Kimberly M. Brown

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)3559-3565
Number of pages7
JournalSurgical Endoscopy and Other Interventional Techniques
Volume25
Issue number11
DOIs
StatePublished - Nov 2011
Externally publishedYes

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Colectomy
Length of Stay
Lymph Nodes

Keywords

  • Colectomy
  • Colorectal cancer
  • Outcomes
  • Single-incision laparoscopic surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Single-incision laparoscopic colectomy for malignant disease. / McNally, Megan E.; Todd Moore, B.; Brown, Kimberly M.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 25, No. 11, 11.2011, p. 3559-3565.

Research output: Contribution to journalArticle

McNally, Megan E. ; Todd Moore, B. ; Brown, Kimberly M. / Single-incision laparoscopic colectomy for malignant disease. In: Surgical Endoscopy and Other Interventional Techniques. 2011 ; Vol. 25, No. 11. pp. 3559-3565.
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AB - 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.

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