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

作者：Takahashi Hidekazu; Takemasa Ichiro; Haraguchi Naotsugu; Nishimura Junichi; Hata Taishi; Yamamoto Hirofumi; Matsuda Chu; Mizushima Tsunekazu; Doki Yuichiro; Mori Masaki

来源：Surgery Today, 2017, 47(8): 966-972.

DOI：10.1007/s00595-016-1457-7

• Colon cancer
• Laparoscopic surgery
• Single-site laparoscopic colectomy
• Complete mesocolic excision
• Central vascular ligation
• Navigation surgery

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.
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).
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).
We successfully standardized SLC for right-sided colon cancer.

• 出版日期2017-8