Annals of Coloproctology

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Original Articles

Clinical Outcomes of Reduced-Port Laparoscopic Surgery for Patients With Sigmoid Colon Cancer: Surgery With 1 Surgeon and 1 Camera Operator: Jung Ryul Oh, Sung Chan Park, Sung Sil Park, Beonghoon Sohn, Hyoung Min Oh, Bun Kim, Min Jung Kim, Chang Won Hong, Kyung Su Han, Dae Kyung Sohn, Jae Hwan Oh; Ann Coloproctol. 2018;34(6):292-298. Published online December 3, 2018; DOI: https://doi.org/10.3393/ac.2018.04.06

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Purpose
This study compared the perioperative clinical outcomes of reduced-port laparoscopic surgery (RPLS) with those of conventional multiport laparoscopic surgery (MPLS) for patients with sigmoid colon cancer and investigated the safety and feasibility of RPLS performed by 1 surgeon and 1 camera operator.
Methods
From the beginning of 2010 until the end of 2014, 605 patients underwent a colectomy for sigmoid colon cancer. We compared the characteristics, postoperative outcomes, and pathologic results for the patients who underwent RPLS and for the patients who underwent MPLS. We also compared the clinical outcomes of single-incision laparoscopic surgery (SILS) and 3-port laparoscopic surgery.
Results
Of the 115 patients in the RPLS group, 59 underwent SILS and 56 underwent 3-port laparoscopic surgery. The MPLS group included 490 patients. The RPLS group had shorter operating time (137.4 ± 43.2 minutes vs. 155.5 ± 47.9 minutes, P < 0.001) and shorter incision length (5.3 ± 2.2 cm vs. 7.8 ± 1.2 cm, P < 0.001) than the MPLS group. In analyses of SILS and 3-port laparoscopic surgery, the SILS group showed younger age, longer operating time, and shorter incision length than the 3-port surgery group and exhibited a more advanced T stage, more lymphatic invasion, and larger tumor size.
Conclusion
RPLS performed by 1 surgeon and 1 camera operator appears to be a feasible and safe surgical option for the treatment of patients with sigmoid colon cancer, showing comparable clinical outcomes with shorter operation time and shorter incision length than MPLS. SILS can be applied to patients with favorable tumor characteristics.

Citations

Citations to this article as recorded by

Efficacy and safety of reduced-port laparoscopic surgery versus conventional laparoscopic surgery for colorectal cancer
Zhi-min Liu, Qi-jun Yao, Fengyun Pei, Fang He, Yandong Zhao, Jun Huang
BMC Cancer.2025;[Epub] CrossRef
Short-term and long-term outcomes of single-incision plus one-port laparoscopic surgery for colorectal cancer: a propensity-matched cohort study with conventional laparoscopic surgery
Mingyi Wu, Hao Wang, Xuehua Zhang, Jiaolong Shi, Xiaoliang Lan, Tingyu Mou, Yanan Wang
BMC Gastroenterology.2023;[Epub] CrossRef
Long-term Oncologic Outcomes of Single-Incision Plus One-Port Laparoscopic Surgery for Rectal Cancer
Yasumitsu Hirano, Chikashi Hiranuma, Masakazu Hattori, Kenji Douden
Indian Journal of Surgery.2021; 83(3): 691. CrossRef
LongTerm Outcomes of Three-Port Laparoscopic Right Hemicolectomy Versus Five-Port Laparoscopic Right Hemicolectomy: A Retrospective Study
Tao Zhang, Yaqi Zhang, Xiaonan Shen, Yi Shi, Xiaopin Ji, Shaodong Wang, Zijia Song, Xiaoqian Jing, Feng Ye, Ren Zhao
Frontiers in Oncology.2021;[Epub] CrossRef
Short‐ And medium‐term outcomes of reduced‐port laparoscopic surgery in elderly patients with upper rectal cancer: A retrospective cohort study
Huawen Wu, Zhijian Zheng, Lewei Xu, Yingying Wu, Ziyi Guan, Wenhuan Li, Guofu Chen
Cancer Medicine.2020; 9(15): 5320. CrossRef

Feasibility of Hand-Assisted Laparoscopic Surgery as Compared to Open Surgery for Sigmoid Colon Cancer: A Case-Controlled Study: Sang Eun Nam, Eun-Joo Jung, Chun-Geun Ryu, Jin Hee Paik, Dae-Yong Hwang; Ann Coloproctol. 2013;29(1):17-21. Published online February 28, 2013; DOI: https://doi.org/10.3393/ac.2013.29.1.17

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Abstract PDF

Purpose

The aim of this study was to evaluate short-term clinical outcomes by comparing hand-assisted laparoscopic surgery (HALS) with open surgery for sigmoid colon cancer.

Methods

Twenty-six patients who underwent a hand-assisted laparoscopic anterior resection (HAL-AR group) and 52 patients who underwent a conventional open anterior resection during the same period were enrolled (open group) in this study with a case-controlled design.

Results

Pathologic parameters were similar between the two groups. The incidences of immediate postoperative leukocytosis were 38.5% in the HAL-AR group and 69.2% in the open group (P = 0.009). There were no significant differences between the two groups as to leukocyte count, hemoglobin, and hematocrits (P = 0.758, P = 0.383, and P = 0.285, respectively). Of the postoperative recovery indicators, first flatus, sips of water and soft diet started on postoperative days 3, 5, 7 in the HALS group and on days 4, 5, 6 in the open group showed statistical significance (P = 0.021, P = 0.259, and P = 0.174, respectively). Administration of additional pain killers was needed for 1.2 days in the HAL-AR group and 2.4 days in the open group (P = 0.002). No significant differences in the durations of hospital stay and the rates of postoperative complications were noted, and no postoperative mortality was encountered in either group.

Conclusion

The patients with sigmoid colon cancer who underwent a HAL-AR had a lower incidence of postoperative leukocytosis, less administration of pain killers, and faster first flatus than those who underwent open surgery. Clinical outcomes for patients' recovery and pathology status were similar between the two groups. Therefore, a HAL-AR for sigmoid colon cancer is feasible and has the same benefit as minimally invasive surgery.

Citations

Citations to this article as recorded by

Hand-assisted laparoscopic surgery versus conventional open surgery in intraoperative and postoperative outcomes for colorectal cancer
Xubing Zhang, Qingbin Wu, Chaoyang Gu, Tao Hu, Liang Bi, Ziqiang Wang
Medicine.2017; 96(33): e7794. CrossRef
Hand-Assisted Laparoscopic Surgery: A Versatile Tool for Colorectal Surgeons
Ju Yong Cheong, Christopher J. Young
Annals of Coloproctology.2017; 33(4): 125. CrossRef
Hand-assisted laparoscopic vs open colectomy: an assessment from the American College of Surgeons National Surgical Quality Improvement Program procedure-targeted cohort
Cigdem Benlice, Meagan Costedio, Luca Stocchi, Maher A. Abbas, Emre Gorgun
The American Journal of Surgery.2016; 212(5): 808. CrossRef
Learning curve for hand-assisted laparoscopic D2 radical gastrectomy
Jia-Qing Gong
World Journal of Gastroenterology.2015; 21(5): 1606. CrossRef
Hand-assisted laparoscopic versus laparoscopy-assisted D2 radical gastrectomy: a prospective study
JiaQing Gong, YongKuan Cao, YunMing Li, GuoHu Zhang, PeiHong Wang, GuoDe Luo
Surgical Endoscopy.2014; 28(10): 2998. CrossRef

Case Reports

Sigmoid Colon Cancer with Metastasis to the Right Spermatic Cord.: Kim, Hyung Jin , Moon, Eun Jung , Kang, Won Kyung , Hong, Seong Hu , Jung, Chan Kwon , Oh, Seong Taek; J Korean Soc Coloproctol. 2007;23(3):203-205.; DOI: https://doi.org/10.3393/jksc.2007.23.3.203

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2 Citations

Abstract PDF

Metastatic tumors involving the spermatic cord are very rare, and the prognosis for such patients is poor. The primary tumors that are frequently metastatic to the spermatic cord are gastric and colon carcinomas. We report a case of a 35-year-old male with a metastatic spermatic cord tumor following a palliative anterior resection for sigmoid colon cancer with peritoneal seeding. The patient complained of a tender mass in a right inguinal lesion. A right orchiectomy was performed, and the pathologic finding was a poorly differentiated adenocarcinoma similar to that of the sigmoid colon cancer.

Citations

Citations to this article as recorded by

Metastatic Spermatic Cord Tumor From Colorectal Cancer
Ji Geon Jang, Hye Yun Jeong, Ki Soo Kim, Mi Jung Park, Jin Sook Lee, Sang Su Kim, Ho Young Kim
Annals of Coloproctology.2015; 31(5): 202. CrossRef
Skeletal Muscle Metastasis from Colorectal Cancer: Report of a Case
Pyong Wha Choi, Chul Nam Kim, Han Seong Kim, Jung Min Lee, Tae Gil Heo, Je Hoon Park, Myung Soo Lee, Surk Hyo Chang
Journal of the Korean Society of Coloproctology.2008; 24(6): 492. CrossRef

Sigmoid Colon Cancer with Isolated Metastasis to the Left Kidney.: Kim, Hyung Jin , Choi, Ho Joong , Kang, Won Kyung , Oh, Soon Nam , Jung, Chan Kwon , Oh, Seong Taek; J Korean Soc Coloproctol. 2006;22(5):346-349.

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Abstract PDF: We report the case of a 63-year-old female with sigmoid colon cancer and isolated metastasis to the left kidney at the time of initial diagnosis. An anterior resection of the sigmoid colon and a left nephrectomy were performed. Three cycles of adjuvant chemotherapy consisting of oxaliplatin, 5-fluorouracil, and leucovorin were given, but two months after the surgery, multiple metastases of the liver were detected on a CT scan. The patient refused further treatment and died 5 months after the discovery of an isolated metastasis. An isolated metastasis to the kidney is very rare in clinical practice. A nephrectomy for kidney metastasis has no effect on survival and quality of life, and a nephrectomy may also compromise the choice of chemotherapy agents that require renal clearance; thus, a careful evaluation of renal function is necessary before a nephrectomy. At present, kidney metastasis should be regarded as an advanced metastatic disease, and aggressive chemotherapy, including target therapy, should prolong survival and improve the quality of life. However, when a synchronous or a metachronous renal tumor is suspected, a nephrectomy should be performed for accurate diagnosis and treatment.

Original Article

Surgical Treatments and Clinical Outcomes of Sigmoid Colon Cancer Adherent to Other Organs.: Kim, Hee Cheol , Hong, Hyoun Kee , Lee, Dong Hee , Yu, Chang Sik , Kim, Jin Cheon; J Korean Soc Coloproctol. 2000;16(4):254-259.

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Abstract PDF: Sigmoid colon cancer occasionally attaches to the adjacent viscera. It is estimated that such attachment occurs in 6% to 12% of all patients with colon carcinoma without distant metastases. This study was performed to identify the parameters to distinguish direct tumor invasion to adjacent organs from simple inflammatory adhesion in sigmoid colon cancer and to clarify the difference of survival and recurrence pattern between two groups.
METHODS
Between 1989 and 1998, 415 patients underwent resection of sigmoid colon cancer in our clinic. Of these, 46 had tumors adherent to adjacent organs and confirmed as tumor direct invasion or simple inflammatory adhesion by pathologic examination. The mean age of 46 cases was 54.2+/-12.8 (mean+/-SD) years and median follow up was 21 (3~53) months.
RESULTS
Among the clinical and pathologic parameters such as symptoms and laboratory findings presenting bowel obstruction, serum CEA levels, preoperative radiological findings, tumor size, differentiation, and stage, there was no specific one that was correlated with direct tumor invasion or inflammatory adhesion. Almost all cases with adhesion to adjacent organ were treated by an en bloc resection including mutivisceral resection. The group with direct invasion had inferior disease free survival rate and overall survival rate comparing with simple inflammatory adhesion group.
CONCLUSIONS
In the situation that there was no valuable parameter suggesting direct tumor invasion, en bloc resection or multivisceral resection involving one tumor-free plane may be beneficial to the patients with sigmoid colon cancer adherent to adjacent organ.

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