Needlescopic surgery for left-sided colorectal cancer

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• 作者：Toshiki Mukai (1)
  Yosuke Fukunaga (1)
  Masashi Ueno (1)
  Satoshi Nagayama (1)
  Yoshiya Fujimoto (1)
  Tsuyoshi Konishi (1)
  Takashi Akiyoshi (1)
  Riki Ono (1)
  Toshiharu Yamaguchi (1)
  
• 关键词：Colorectal cancer ; Minimally invasive surgery ; Needlescopic surgery ; Reduced port surgery
• 刊名：International Journal of Colorectal Disease
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：29
• 期：12
• 页码：1501-1505
• 全文大小：628 KB
• 参考文献：1. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718-726 CrossRef
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• 作者单位：Toshiki Mukai (1)
  Yosuke Fukunaga (1)
  Masashi Ueno (1)
  Satoshi Nagayama (1)
  Yoshiya Fujimoto (1)
  Tsuyoshi Konishi (1)
  Takashi Akiyoshi (1)
  Riki Ono (1)
  Toshiharu Yamaguchi (1)
  
  1. Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan
  
• ISSN：1432-1262

文摘

Purpose Laparoscopic surgery has become the standard for colorectal cancers, but more minimally invasive surgery is continuously pursued. In June 2011, our institution started needlescopic surgery (NS). The aims of this study are to describe this technique and to investigate its feasibility for left-sided colorectal cancer surgery. Methods From June 2011 to June 2013, 105 sigmoid colon and upper/middle rectal cancer patients underwent NS in our institution, involving one 5-mm port and three 3-mm ports, with the exception of an umbilical 12-mm port. A 10-mm scope is used through the umbilical 12-mm port, which will be extended to a small skin incision for specimen extraction. After dissection of the left colon, a 5-mm scope is inserted through the right lower 5-mm port and a linear stapler is inserted through the umbilical 12-mm port for rectal transection. The specimen is then extracted through umbilical incision, and the anastomosis is carried out by the double-staple technique. Results TNM staging is stage 0/I/II/III/IV--/31/32/31/11. Fifty-one patients underwent sigmoidectomy and 54 patients underwent anterior resection. There was no conversion to open surgery, but one patient required a change to a 5-mm port from one of the 3-mm ports. Mean operating time was 193?min and mean estimated blood loss was 12?ml. There were ten (9?%) postoperative complications: two anastomotic leaks requiring reoperation, two anastomotic hemorrhages, and one wound infection. There was no mortality. Conclusions NS for left-sided colorectal cancer was a technically and oncologically feasible technique for selected patients.