In the MIS group the most common complication was anastomotic leak (n = 2), followed by wound infection (n = 1), pelvic abscess (n = 1), and respiratory failure (n = 1). One patient with anastomotic leak was reoperated during the same hospital stay selleck inhibitor and the other case was readmitted for reintervention. The pelvic abscess required readmission and was managed with percutaneous drainage. These similar results between SILC and CLC with regard to postoperative complications are consistent with the reported literature [10, 11]. The pathological evaluation demonstrated that all MIS techniques result in oncologically sound outcomes. In all cases the specimen had tumor-free proximal and distal margins. There was a slight, nonsignificant, difference in the median number of lymph nodes harvested between the SILC and MIS groups, 19.
5 and 17, respectively. This was in accordance with current colorectal cancer guidelines . In order to accomplish suitable oncological outcomes during minimally invasive colectomy, some technical considerations have to be taken into account. We perform a technique in which the neoplastic lesion is not manipulated during the procedure, thus eliminating the potential for intraperitoneal tumor seeding. The high ligation of vascular pedicles is also performed so as to maximize lymph node extraction, in addition to the utilization of a wound protector for specimen extraction in order to eliminate tumor seeding at the extraction site. The main limitation of this study was relatively small sample size and is limited to short-term followup.
We matched the SILC cases to a series of HALC and CLC cases to overcome the small sample size, which may negatively affect comparisons. Moreover, the SILC procedures represent the initial experience of the surgeons with the single-incision platform, whereas the MIS group consisted of procedures performed after hundreds of cases of HALC and CLC. Although this would have resulted in poor SILC outcomes, this learning curve discrepancy did not compromise the results following the SILC technique, which compared similarly to the MIS group. Single-incision laparoscopic surgery is a safe and efficacious alternative MIS approach for the management of colonic malignancies when performed by an experienced surgeon.
This technique results in similar short-term operative and oncological outcomes when compared to well-established laparoscopic approaches such as conventional multiport and hand-assisted laparoscopic surgery. Presentation Poster AV-951 presentation is at the meeting of The American Society of Colon and Rectal Surgeons, San Antonio, TX, June 2 to 6, 2012. Conflict of Interests Dr. Pedraza, Dr. Aminian, Dr. Nieto, Dr. Faraj, Dr. Pickron, and Dr. Haas have no conflict of interests or financial ties to disclose.
No related posts.