Fujino Shiki, Miyoshi Norikatsu, Ohue Masayuki, Noura Shingo, Fujiwara Yoshiyuki, Higashiyama Masahiko, Yano Masahiko
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
Mol Clin Oncol. 2016 Apr;4(4):611-615. doi: 10.3892/mco.2016.757. Epub 2016 Jan 29.
Laparoscopic surgery for colorectal cancer (CRC) has recently gained in popularity due to the fewer trocars and shorter incision, leading to reduced wound pain and improved cosmetic outcome. In July, 2013, reduced-port surgery (RPS) was introduced and has been performed thereafter in our hospital. An umbilical incision is used for a main port in RPS, through which the specimen is removed and the anastomosis is performed. In order to make the incision shorter, we introduced the Z skin incision in RPS. In this study, we aimed to discuss this method and evaluate the short-term outcome. Among CRC patients undergoing RPS, Z skin incision (n=14) was compared to conventional skin incision (n=15). The clinical and surgical factors were evaluated and there were no significant differences in terms of gender, age, body mass index, tumor site, procedure, operative time, blood loss or complications between the two groups. The median incision length at the umbilicus was significantly shorter in the Z incision group (P=0.004). Particularly in functional end-to-end anastomosis, the median incision length was 2.5 cm in the Z skin incision group and 4.0 cm in the conventional incision group (P=0.018). In conclusion, Z skin incision is a useful technique for achieving an effective length of skin incision in RPS for CRC.
由于腹腔镜手术切口小、套管针数量少,可减轻伤口疼痛并改善美观效果,因此腹腔镜结直肠癌(CRC)手术近年来越来越受欢迎。2013年7月,我院引入了减孔手术(RPS)并此后一直开展。在RPS中,脐部切口用作主操作孔,通过该孔取出标本并进行吻合。为了缩短切口长度,我们在RPS中引入了Z形皮肤切口。在本研究中,我们旨在探讨该方法并评估短期疗效。在接受RPS的CRC患者中,将Z形皮肤切口组(n = 14)与传统皮肤切口组(n = 15)进行比较。评估了临床和手术因素,两组在性别、年龄、体重指数、肿瘤部位、手术方式、手术时间、失血量或并发症方面无显著差异。Z形切口组脐部切口的中位长度明显更短(P = 0.004)。特别是在功能性端端吻合术中,Z形皮肤切口组的中位切口长度为2.5 cm,传统切口组为4.0 cm(P = 0.018)。总之,Z形皮肤切口是一种在CRC的RPS中实现有效皮肤切口长度的有用技术。