Department of Colon and Rectal Surgery, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Gwangju, Hwasun-gun, Jeollanam-do, 519-763, South Korea.
Tech Coloproctol. 2013 Apr;17(2):193-9. doi: 10.1007/s10151-012-0900-z. Epub 2012 Sep 19.
Recently, laparoscopic colorectal surgery using a single incision usually made at the umbilical area has emerged as a tool to minimize the numbers of scars and provide better cosmetic results. But experience in laparoscopic skills is needed to maintain the oncologic principles of colorectal cancer surgery with the restricted operating field during the procedure. Adding an additional port to single-incision laparoscopic colorectal surgery (SILS) may be a bridge between conventional multiport laparoscopic surgery and SILS. The present study was undertaken to investigate whether umbilical incision laparoscopic colorectal cancer surgery with one additional port (ULAP) could be performed in a similar manner to conventional multiport surgery.
One hundred and sixty-three patients with colorectal adenocarcinoma underwent laparoscopic colectomy between February 2011 and August 2011. Forty of these patients underwent ULAP and were compared with the other 123 patients who had conventional laparoscopic surgery. Demographic, intraoperative, and postoperative data were analyzed.
Both groups were similar in age (p = 0.438), gender (p = 0.818), body mass index (p = 0.149), American Society of Anesthesiologists (ASA) scores (p = 0.417), history of previous abdominal operation (p = 0.503), and tumor location (p = 0.051). Operation time was longer in the ULAP group (255.5 min) than in the conventional laparoscopic surgery group (144.6 min) (p < 0.001). No significant differences were evident between groups for estimated blood loss (p = 0.263), transfusion requirements (p = 0.841), conversion to open procedures (p = 0.40), length of umbilical incisions (4.6 vs. 4.4 cm, p = 0.628), postoperative hospital stay (p = 0.862), tumor size (p = 0.455), number of harvested lymph nodes (p = 0.203), proximal margins (p = 0.189), and distal resection margins (p = 0.151). Postoperative morbidity (p = 0.736) was similar in both groups. There was no mortality postoperatively.
Umbilical incision laparoscopic colorectal cancer surgery with an additional port is a feasible and safe approach, although it is more time consuming than conventional laparoscopic colectomy.
最近，使用单一切口的腹腔镜结直肠手术已成为一种减少切口数量和提供更好美容效果的工具，通常在脐部进行。但在手术过程中，需要有腹腔镜技能经验来维持结直肠癌手术的肿瘤学原则。在单切口腹腔镜结直肠手术（SILS）中增加一个附加端口可能是传统多孔腹腔镜手术和 SILS 之间的桥梁。本研究旨在探讨脐部切口腹腔镜结直肠癌手术加一个附加端口（ULAP）是否可以以类似于传统多孔手术的方式进行。
2011 年 2 月至 2011 年 8 月期间，163 例结直肠腺癌患者接受腹腔镜结肠切除术。其中 40 例患者接受 ULAP，并与其他 123 例接受传统腹腔镜手术的患者进行比较。分析了人口统计学、术中及术后数据。
两组患者的年龄（p=0.438）、性别（p=0.818）、体重指数（p=0.149）、美国麻醉医师协会（ASA）评分（p=0.417）、既往腹部手术史（p=0.503）和肿瘤位置（p=0.051）均相似。ULAP 组的手术时间（255.5 分钟）长于传统腹腔镜手术组（144.6 分钟）（p<0.001）。两组的估计失血量（p=0.263）、输血需求（p=0.841）、转为开放手术（p=0.40）、脐部切口长度（4.6 与 4.4cm，p=0.628）、术后住院时间（p=0.862）、肿瘤大小（p=0.455）、淋巴结清扫数量（p=0.203）、近端切缘（p=0.189）和远端切除边缘（p=0.151）均无显著差异。两组术后发病率（p=0.736）相似。术后无死亡。
附加端口的脐部切口腹腔镜结直肠癌手术是一种可行且安全的方法，尽管它比传统腹腔镜结肠切除术耗时更长。
