Summary
Background
Dual-port laparoscopic colectomy (DPLC) has emerged as a surgical option that can overcome the technical limitations of single-port laparoscopic colectomy (SPLC). The aim of this study was to compare perioperative outcomes of DPLC and SPLC for colon cancer.
Patients and methods
This case-control study assessed 119 patients who underwent colon cancer surgery using DPLC (n = 66) and SPLC (n = 53).
Results
Propensity score matching resulted in 42 pairs of patients, equivalent in distribution of TNM stage and tumor size. Perioperative outcomes and postoperative complications were similar in the two groups, except for a tendency toward less blood loss in the DPLC group (50 ml vs. 100 ml, p = 0.087). Umbilical incision sites were significantly more common in the DPLC than in the SPLC group with left-sided colon cancer (94.4% vs. 66.7%, p = 0.032). In a subgroup of patients with stage II–IV tumors, there were no significant between-group differences in perioperative outcomes.
Conclusion
These findings show that perioperative outcomes following colon cancer surgery with DPLC were not superior to those achieved with SPLC. DPLC may be associated with better cosmetic outcomes through greater use of an umbilical approach for left-sided colectomies.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Jayne DG, Guillou PJ, Thorpe H, UK MRC CLASICC Trial Group, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3‑year results of the UK MRC CLASICC trial group. J Clin Oncol. 2007;25(21):3061–8.
Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350(20):2050–9.
Lacy AM, García-Valdecasas JC, Delgado S, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: A randomised trial. Lancet. 2002;359(9325):2224–9.
Remzi FH, Kirat HT, Kaouk JH, et al. Single-port laparoscopy in colorectal surgery. Colorectal Dis. 2008;10(8):823–6.
Hasegawa F, Kawamura Y, Sasaki J, et al. Oncological 3‑port laparoscopic colectomy by 1 surgeon and 1 camera operator: a preliminary report. Surg Laparosc Endosc Percutan Tech. 2013;23(2):176–9.
Katsuno G, Fukunaga M, Nagakari K, et al. Short-term and long-term outcomes of single-incision versus multi-incision laparoscopic resection for colorectal cancer: A propensity-score-matched analysis of 214 cases. Surg Endosc. 2016;30(4):1317–25.
Poon JT, Cheung C, Fan JK, et al. Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized, controlled trial. Surg Endosc. 2012;26(10):2729–34.
McNally M, Todd Moore B, Brown K. Single-incision laparoscopic colectomy for malignant disease. Surg Endosc. 2011;25(11):3559–65.
Kim H, Kang B, Lee S, et al. Single-port laparoscopic colorectal cancer surgery in Korea: retrospective analysis of the multicenter, pooled database. J Laparoendosc Adv Surg Tech A. 2014;24(7):462–5.
Yun J, Yun S, Park Y, et al. Oncologic outcomes of single-incision laparoscopic surgery compared with conventional laparoscopy for colon cancer. Ann Surg. 2016;263(5):973–8.
Tashiro J, Yamaguchi S, Ishii T, et al. Initial experience of reduced port surgery using a two-surgeon technique for colorectal cancer. BMC Surg. 2015;15:91.
Lim SW, Kim HJ, Kim CH, et al. Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer. Tech Coloproctol. 2013;17(2):193–9.
Makino T, Milsom J, Lee S. Feasibility and safety of single-incision laparoscopic colectomy: A systematic review. Ann Surg. 2012;255(4):667–76.
Yu H, Shin J. Short-term outcomes following reduced-port, single-port, and multi-port laparoscopic surgery for colon cancer: Tailored laparoscopic approaches based on tumor size and nodal status. Int J Colorectal Dis. 2016;31(1):115–22.
D’Agostino RB. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998;17(19):2265–81.
Kawamata F, Homma S, Minagawa N, et al. Comparison of single-incision plus one additional port laparoscopy-assisted anterior resection with conventional laparoscopy-assisted anterior resection for rectal cancer. World J Surg. 2014;38(10):2716–23.
Jung K, Yun S, Cho Y, et al. Single incision and reduced port laparoscopic low anterior resection for rectal cancer: Initial experience in 96 cases. ANZ J Surg. 2016;86(5):403–7.
Champagne BJ, Lee EC, Leblanc F, et al. Single-incision vs straight laparoscopic segmental colectomy: A case-controlled study. Dis Colon Rectum. 2011;54(2):183–6.
Lai W, Lin Y, Lee K, et al. The application of McBurney’s single-incision laparoscopic colectomy alleviates the response of patients to postoperative wound pain. J Laparoendosc Adv Surg Tech A. 2014;24(9):606–11.
Kim S, Ryu G, Choi B, et al. The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer. Ann Surg. 2011;254(6):933–40.
Keller D, Flores Gonzalez J, Sandhu J, et al. SILS v SILS+1: A case-matched comparison for colorectal surgery. J Gastrointest Surg. 2015;19(10):1875–9.
Acknowledgements
Statistical analysis was performed by Pusan National University Hospital Clinical Trial Center Biostatistics Office.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
J.Y. Shin declares that (s)he has no competing interests.
Ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Shin, J.Y. Dual-port vs. single-port laparoscopic colectomy for colon cancer. Eur Surg 49, 228–235 (2017). https://doi.org/10.1007/s10353-017-0482-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10353-017-0482-0