The single-center experience with the standardization of single-site laparoscopic colectomy for right-sided colon cancer

Surg Today. 2017 Aug;47(8):966-972. doi: 10.1007/s00595-016-1457-7. Epub 2016 Dec 20.

Abstract

Purpose: Complete mesocolic excision (CME) with central vascular ligation (CVL) has been widely accepted as a surgical treatment for right-sided colon cancer. Single-site laparoscopic colectomy (SLC) is associated with reduced pain and improved cosmesis, in comparison to the multi-site laparoscopic colectomy (MCL). Although the feasibility of CME + CVL under MCL has been reported, SLC for right-sided colon cancer is generally challenging. The purpose of this study is to demonstrate our efforts to standardize the SLC for right-sided colon cancer.

Methods: This retrospective study enrolled 202 consecutive patients with right-sided colon cancer who underwent laparoscopic colectomy for right-sided colon cancer, using an inferior approach and intraoperative navigation surgery, between 2008 and 2014. The patients were divided into 3 groups, based on the period of treatment, as follows: Period I (2008-2009, n = 56), Period II (2010-2011, n = 70), and Period III (2012-2014, n = 76).

Results: The patient's baseline characteristics did not differ among the three periods. The ratio of SLC significantly increased with the passage of the time. The short-term outcomes were similar among the three periods. As for oncological clearance, there was a significant increase in the number of resected lymph nodes with the passage of the time (P < 0.05).

Conclusions: We successfully standardized SLC for right-sided colon cancer.

Keywords: Central vascular ligation; Colon cancer; Complete mesocolic excision; Laparoscopic surgery; Navigation surgery; Single-site laparoscopic colectomy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Colectomy / methods
  • Colectomy / standards*
  • Colonic Neoplasms / surgery*
  • Feasibility Studies
  • Female
  • Humans
  • Laparoscopy / methods
  • Laparoscopy / standards*
  • Ligation / methods
  • Lymph Node Excision
  • Male
  • Mesocolon / surgery
  • Middle Aged
  • Retrospective Studies