Department of Surgery, Juntendo Urayasu Hospital, Juntendo University, Tomioka, Urayasu, Japan.
Dis Colon Rectum. 2011 Jun;54(6):705-10. doi: 10.1007/DCR.0b013e3182107ca5.
Transumbilical single-port surgery has been developed with the aim to further reduce the invasiveness of conventional laparoscopy.
This study aimed to report our experience with 31 patients who were treated with transumbilical single-incision laparoscopic colectomy for colon cancer.
This is a retrospective review of prospectively gathered data.
This study was conducted at the Department of Surgery of Juntendo University Urayasu Hospital between April 2009 and April 2010. Data were obtained from a prospectively maintained single-institution laparoscopic colon cancer database.
Thirty-one consecutively selected patients (mean BMI, 22.5 ± 2.3) were evaluated.
All patients underwent single-incision laparoscopic colectomy for colon cancer. Two different approaches were used for single-incision laparoscopic colectomy: the trocar insertion method and the SILS port method. The trocar insertion method was adopted in 22 of 31 patients, and the SILS port method was used in 9 patients.
The main measures of outcomes were intraoperative findings, postoperative course, and oncological outcomes.
The most common procedure was sigmoid colon resection performed in 12 of 31 (39%) patients. The mean skin incision was 2.72 ± 0.79 (range, 3-5) cm. The operating time ranged from 101 to 263 (mean, 156 ± 45) minutes. The volume of bleeding ranged from 5 to 60 (mean, 27 ± 19) mL. No intraoperative complications were observed in this series. Postoperatively, there was no mortality. Wound infection was observed in 1 patient. The number of harvested lymph nodes was 18 ± 2.1, and the mean tumor-free resection margin was 11 ± 4.8 cm.
Our experience indicates that single-incision laparoscopic colectomy is feasible for selected patients with colon cancer.
经脐单孔腹腔镜手术的发展旨在进一步降低传统腹腔镜手术的侵袭性。
本研究旨在报告我们对 31 例接受经脐单切口腹腔镜结肠癌根治术治疗的结肠癌患者的经验。
这是一项前瞻性收集数据的回顾性研究。
本研究于 2009 年 4 月至 2010 年 4 月在顺天堂大学浦安市医院外科进行。数据来自一个前瞻性维持的单机构腹腔镜结肠癌数据库。
连续选择了 31 例患者(平均 BMI,22.5 ± 2.3)进行评估。
所有患者均接受经脐单切口腹腔镜结肠癌根治术。单切口腹腔镜结肠切除术采用两种不同的方法:套管插入法和 SILS 端口法。31 例患者中有 22 例采用套管插入法,9 例采用 SILS 端口法。
主要观察指标为术中发现、术后过程和肿瘤学结果。
最常见的手术是 31 例患者中的 12 例(39%)进行的乙状结肠切除术。皮肤切口平均为 2.72 ± 0.79(范围,3-5)cm。手术时间为 101-263 分钟(平均 156 ± 45 分钟)。出血量为 5-60 毫升(平均 27 ± 19 毫升)。本系列术中无并发症。术后无死亡。1 例患者发生伤口感染。采集的淋巴结数为 18 ± 2.1 个,平均肿瘤无残留切缘为 11 ± 4.8cm。
我们的经验表明,单切口腹腔镜结肠癌根治术对选定的结肠癌患者是可行的。