Single-incision laparoscopic colectomy for colon cancer: early experience with 31 cases.

Katsuno, Goutaro; Fukunaga, Masaki; Nagakari, Kunihiko; Yoshikawa, Seichiro; Ouchi, Masakazu; Hirasaki, Yoshinori

BACKGROUND Transumbilical single-port surgery has been developed with the aim to further reduce the invasiveness of conventional laparoscopy. OBJECTIVE This study aimed to report our experience with 31 patients who were treated with transumbilical single-incision laparoscopic colectomy for colon cancer. DESIGN This is a retrospective review of prospectively gathered data. SETTINGS 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. PATIENTS Thirty-one consecutively selected patients (mean BMI, 22.5 ± 2.3) were evaluated. INTERVENTIONS 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. MAIN OUTCOME MEASURES The main measures of outcomes were intraoperative findings, postoperative course, and oncological outcomes. RESULTS 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. CONCLUSION Our experience indicates that single-incision laparoscopic colectomy is feasible for selected patients with colon cancer.