Single-incision laparoscopic colectomy for cancer: assessment of oncologic resection and short-term outcomes in a case-matched comparison with standard laparoscopy

Surgery. 2011 Oct;150(4):820-7. doi: 10.1016/j.surg.2011.07.060.

Abstract

Purpose: To compare single-incision laparoscopic (SIL) with multiport laparoscopic (LAP) colectomy in patients with colon cancer to assess oncologic resection and 1-year outcomes.

Methods: We compared patients who underwent SIL colectomy for colon cancer with an equal number of case-matched LAP colectomy patients based on age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA) score, previous abdominal operations, and operation type. Results of oncologic resection included lymph node (LN) yield and margins. One-year outcomes included cancer recurrence and death.

Results: Twenty-six patients were identified for SIL and LAP colectomy groups with no differences in case matching (age, P = .70; gender, P > .99; BMI, P = .74; ASA score, P > .99; previous abdominal operation, P > .99; and operation-type, P > .99). Oncologic resection was similar for both groups. Mean LN yield was 17 (P = .88). There were no positive margins and 2 (8%) patients had proximal/distal margin of <5 cm in each group. The mean follow-up was 13 and 21 months for the SIL and LAP groups, respectively (P < .001), with 2(8%) recurrences in each group, and no port-site recurrences or deaths. Disease-free survival at 1 year was 92% for both groups.

Conclusion: These data suggest that SIL colectomy for cancer provides equivalent oncologic resection and 1-year outcomes compared with a standard LAP technique. Further studies are required to determine long-term oncologic outcomes, including recurrence and survival rates.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colectomy / methods*
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Disease-Free Survival
  • Female
  • Humans
  • Laparoscopy / methods*
  • Length of Stay
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Neoplasm Recurrence, Local / pathology
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome