Mori Shinichiro, Kita Yoshiaki, Baba Kenji, Yanagi Masayuki, Okumura Hiroshi, Natsugoe Shoji
Department of Digestive, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
Dig Surg. 2015;32(1):45-51. doi: 10.1159/000373895. Epub 2015 Feb 11.
Laparoscopic colectomy has become accepted for resection of colon cancer, and laparoscopic complete mesocolic excision (CME) has proved feasible and safe. We have evaluated the safety, efficacy, and feasibility of laparoscopic CME via reduced port surgery (RPS) in patients with colon cancer.
We prospectively assessed 17 consecutive patients with colon cancer undergoing laparoscopic CME via RPS between February 2012 and January 2014. Video recordings were used to assess the quality of the surgery, including CME completion. We also assessed operative data, complications, pathological findings, visual analog scale (VAS), cosmesis, and the hospital length of stay.
All patients underwent en bloc resection of mesocolon with CME completion. The median surgical duration and blood loss were 298 min and 41 ml, respectively. No intraoperative complications occurred in any patient. The median number of lymph nodes retrieved was 20, with lymph node metastasis identified in eight patients. The mean VAS scores for postoperative days 1, 3, and 7 were 3.2, 1.5, and 0, respectively. All patients were satisfied with their cosmesis. The median postoperative hospital stay was 11 days.
Laparoscopic CME via RPS for colon cancer is a safe and feasible surgical procedure with cosmetic advantages.
腹腔镜结肠切除术已被广泛接受用于结肠癌的切除，并且腹腔镜完整结肠系膜切除术（CME）已被证明是可行且安全的。我们评估了通过减孔手术（RPS）对结肠癌患者进行腹腔镜CME的安全性、有效性和可行性。
我们前瞻性地评估了2012年2月至2014年1月期间连续17例通过RPS接受腹腔镜CME的结肠癌患者。使用视频记录来评估手术质量，包括CME的完成情况。我们还评估了手术数据、并发症、病理结果、视觉模拟评分（VAS）、美容效果和住院时间。
所有患者均完成了结肠系膜的整块切除并完成了CME。中位手术时间和失血量分别为298分钟和41毫升。所有患者均未发生术中并发症。中位获取淋巴结数为20个，8例患者发现有淋巴结转移。术后第1天、第3天和第7天的平均VAS评分分别为3.2、1.5和0。所有患者对其美容效果均满意。术后中位住院时间为11天。
通过RPS对结肠癌进行腹腔镜CME是一种安全可行的手术方法，具有美容优势。
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