Single-incision laparoscopic surgery for locally advanced colorectal cancer : feasibility, short-term and oncologic outcomes
Journal | Volume 81 - 2018 |
Issue | Fasc.1 - Original articles |
Author(s) | F. Famiglietti, D. Leonard, R. Bachmann, C. Remue, N. Abbes Orabi, A. Van Maanen, M. Van Den Eynde, A. Kartheuser |
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(1) Colorectal Surgery Unit ; (2) Statistical Support Unit, Institut Roi Albert II ; (3) Departement of Oncology ; (4) Departement of Hepato-gatroenterology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium. |
Background and study aims : Data about single-incision laparoscopic surgery (SILS) in locally advanced colorectal cancers are scarce. This study aimed to evaluate perioperative and short- term oncologic outcomes of SILS in pT3-T4 colorectal cancer. Patients and methods : From 2011 to 2015 data from 249 SILS performed in our Colorectal Unit were entered into a prospective database. Data regarding patients with a pT3-T4 colorectal adenocarcinoma were compared to those with pTis-pT2. Factors influencing conversion were assessed by multivariate analysis. Results : There were 100 consecutive patients (T3-T4 = 70, Tis- T2 = 30). Demographics were similar. Tumor size was significantly larger in the T3-T4 group [3.9cm vs 2cm; p<0.001]. In T3-T4 patients we found a significant higher number of lymph nodes harvested [20 vs 13 ; p<0.001]. Early (<30 days) severe (Clavien- Dindo classification>2) postoperative complication rate was similar between groups (8.6% vs 10% ; p = 0.999), as well as conversion rate (18.6% vs 6.7% ; p = 0.220). Finally, there were no differences in terms of hospital stay and mortality rate. On multivariate analysis, age (OR = 1.06, 95%CI: 1.012-1.113 ; p = 0.015] and stage IV (OR = 5.372, 95%CI: 1.320-21.862, p = 0.019) were independently associated with conversion. Conclusions : SILS for locally advanced colorectal cancer did not affect the short-term outcomes in this series and oncological clearance remained satisfactory. Age and stage IV disease are independent risk factors for conversion. (Acta Gastroenterol. belg., 2018, 81, 23-28). |
© Acta Gastro-Enterologica Belgica. PMID 29562374 |