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Single-Port Laparoscopic TME with Low Colorectal Anastomosis

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Surgical Techniques in Rectal Cancer

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Abstract

Although single-port laparoscopy for colorectal resections was initially only performed for benign disease, there is now an increasing experience for colorectal malignancy. On the other hand, as with standard multiport laparoscopic approach in rectal cancer management, single-port laparoscopy for rectal procedures raises some concern about feasibility and safety of this technically demanding surgery. To date, only few studies reported the postoperative results of this minimally invasive approach, and no randomized control trial including rectal procedures is available. However, the results of these studies and of those of systematic reviews suggest that single-port rectal surgery may be associated with satisfactory postoperative morbidity rate and might even improve the postoperative recovery. However, long-term follow-up of single-port laparoscopic total mesorectal excision (SPLTME) for rectal cancer has not been reported in any study. In this chapter we will review the available literature on the topic and detail our surgical technique for SPLTME.

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References

  1. Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350:2050–9.

    Article  Google Scholar 

  2. Lujan J, Valero G, Hernandez Q, Sanchez A, Frutos MD, Parrilla P. Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer. Br J Surg. 2009;96:982–9.

    Article  CAS  PubMed  Google Scholar 

  3. Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, et al. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg. 2007;246:655–64.

    Article  PubMed  Google Scholar 

  4. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6:477–84.

    Article  PubMed  Google Scholar 

  5. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365:1718–26.

    Article  PubMed  Google Scholar 

  6. Panis Y, Maggiori L, Caranhac G, Bretagnol F, Vicaut E. Mortality after colorectal cancer surgery: a French survey of more than 84,000 patients. Ann Surg. 2011;254:738–44.

    Article  PubMed  Google Scholar 

  7. Kang SB, Park JW, Jeong SY, Nam BH, Choi HS, Kim DW, et al. Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol. 2010;11:637–45.

    Article  PubMed  Google Scholar 

  8. van der Pas MH, Haglind E, Cuesta MA, Furst A, Lacy AM, Hop WC, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013;14:210–8.

    Article  PubMed  Google Scholar 

  9. Hamzaoglu I, Karahasanoglu T, Baca B, Karatas A, Aytac E, Kahya AS. Single-port laparoscopic sphincter-saving mesorectal excision for rectal cancer: report of the first 4 human cases. Arch Surg. 2011;146:75–81.

    Article  PubMed  Google Scholar 

  10. Gaujoux S, Bretagnol F, Au J, Ferron M, Panis Y. Single port access proctectomy with total mesorectal excision and intersphincteric resection with a primary transanal approach. Color Dis. 2011;13:e305–7.

    Article  CAS  Google Scholar 

  11. Gaujoux S, Maggiori L, Bretagnol F, Ferron M, Panis Y. Safety, feasibility, and short-term outcomes of single port access colorectal surgery: a single institutional case-matched study. J Gastrointest Surg. 2012;16:629–34.

    Article  PubMed  Google Scholar 

  12. Bulut O, Nielsen CB, Jespersen N. Single-port access laparoscopic surgery for rectal cancer: initial experience with 10 cases. Dis Colon Rectum. 2011;54:803–9.

    Article  PubMed  Google Scholar 

  13. Bulut O, Aslak KK, Rosenstock S. Technique and short-term outcomes of single-port surgery for rectal cancer: a feasibility study of 25 patients. Scand J Surg. 2014;103:26–33. [Epub ahead of print]

    Article  CAS  PubMed  Google Scholar 

  14. Kim SJ, Ryu GO, Choi BJ, Kim JG, Lee KJ, Lee SC, et al. The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer. Ann Surg. 2011;254:933–40.

    Article  PubMed  Google Scholar 

  15. Vestweber B, Galetin T, Lammerting K, Paul C, Giehl J, Straub E, et al. Single-incision laparoscopic surgery: outcomes from 224 colonic resections performed at a single center using SILS. Surg Endosc. 2013;27:434–42.

    Article  PubMed  Google Scholar 

  16. Champagne BJ, Papaconstantinou HT, Parmar SS, Nagle DA, Young-Fadok TM, Lee EC, et al. Single-incision versus standard multiport laparoscopic colectomy: a multicenter, case-controlled comparison. Ann Surg. 2012;255:66–9.

    Article  PubMed  Google Scholar 

  17. Sourrouille I, Dumont F, Goere D, Honore C, Elias D. Resection of rectal cancer via an abdominal single-port access: short-term results and comparison with standard laparoscopy. Dis Colon Rectum. 2013;56:1203–10.

    PubMed  Google Scholar 

  18. Maggiori L, Gaujoux S, Tribillon E, Bretagnol F, Panis Y. Single-incision laparoscopy for colorectal resection: a systematic review and meta-analysis of more than a thousand procedures. Color Dis. 2012;14:e643–54.

    Article  CAS  Google Scholar 

  19. Gash KJ, Goede AC, Chambers W, Greenslade GL, Dixon AR. Laparoendoscopic single-site surgery is feasible in complex colorectal resections and could enable day case colectomy. Surg Endosc. 2011;25:835–40.

    Article  CAS  PubMed  Google Scholar 

  20. Geisler DP, Kirat HT, Remzi FH. Single-port laparoscopic total proctocolectomy with ileal pouch-anal anastomosis: initial operative experience. Surg Endosc. 2011;25:2175–8.

    Article  PubMed  Google Scholar 

  21. Chambers WM, Bicsak M, Lamparelli M, Dixon AR. Single-incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis. Color Dis. 2011;13:393–8.

    Article  CAS  Google Scholar 

  22. Chew MH, Wong MT, Lim BY, Ng KH, Eu KW. Evaluation of current devices in single-incision laparoscopic colorectal surgery: a preliminary experience in 32 consecutive cases. World J Surg. 2011;35:873–80.

    Article  PubMed  Google Scholar 

  23. Leblanc F, Makhija R, Champagne BJ, Delaney CP. Single incision laparoscopic total colectomy and proctocolectomy for benign disease: initial experience. Color Dis. 2011;13:1290–3.

    Article  CAS  Google Scholar 

  24. Podolsky ER, Curcillo PG 2nd. Single port access (SPA) surgery--a 24-month experience. J Gastrointest Surg. 2010;14:759–67.

    Article  PubMed  Google Scholar 

  25. Ross H, Steele S, Whiteford M, Lee S, Albert M, Mutch M, et al. Early multi-institution experience with single-incision laparoscopic colectomy. Dis Colon Rectum. 2011;54:187–92.

    Article  CAS  PubMed  Google Scholar 

  26. Gash KJ, Goede AC, Kaldowski B, Vestweber B, Dixon AR. Single incision laparoscopic (SILS) restorative proctocolectomy with ileal pouch-anal anastomosis. Surg Endosc. 2011;25:3877–80.

    Article  CAS  PubMed  Google Scholar 

  27. van den Boezem PB, Sietses C. Single-incision laparoscopic colorectal surgery, experience with 50 consecutive cases. J Gastrointest Surg. 2011;15:1989–94.

    Article  PubMed  Google Scholar 

  28. Uematsu D, Akiyama G, Narita M, Magishi A. Single-access laparoscopic low anterior resection with vertical suspension of the rectum. Dis Colon Rectum. 2011;54:632–7.

    Article  PubMed  Google Scholar 

  29. Lauritsen ML, Bulut O. Single-port access laparoscopic abdominoperineal resection through the colostomy site: a case report. Tech Coloproctol. 2012;16:175–7.

    Article  CAS  PubMed  Google Scholar 

  30. Lee SW, Milsom JW, Nash GM. Single-incision versus multiport laparoscopic right and hand-assisted left colectomy: a case-matched comparison. Dis Colon Rectum. 2011;54:1355–61.

    Article  PubMed  Google Scholar 

  31. Geisler D, Garrett T. Single incision laparoscopic colorectal surgery: a single surgeon experience of 102 consecutive cases. Tech Coloproctol. 2011;15:397–401.

    Article  CAS  PubMed  Google Scholar 

  32. Bulut O, Nielsen CB. Single-incision laparoscopic low anterior resection for rectal cancer. Int J Color Dis. 2010;25:1261–3.

    Article  Google Scholar 

  33. Geisler DP, Condon ET, Remzi FH. Single incision laparoscopic total proctocolectomy with ileopouch anal anastomosis. Color Dis. 2010;12:941–3.

    Article  CAS  Google Scholar 

  34. Makino T, Milsom JW, Lee SW. Feasibility and safety of single-incision laparoscopic colectomy: a systematic review. Ann Surg. 2012;255:667–76.

    Article  PubMed  Google Scholar 

  35. Fung AK, Aly EH. Systematic review of single-incision laparoscopic colonic surgery. Br J Surg. 2012;99:1353–64.

    Article  PubMed  Google Scholar 

  36. Huscher CG, Mingoli A, Sgarzini G, Mereu A, Binda B, Brachini G, et al. Standard laparoscopic versus single-incision laparoscopic colectomy for cancer: early results of a randomized prospective study. Am J Surg. 2012;204:115–20.

    Article  PubMed  Google Scholar 

  37. Poon JT, Cheung CW, Fan JK, Lo OS, Law WL. Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized, controlled trial. Surg Endosc. 2012;26:2729–34.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Pôle des Maladies de l’Appareil Digestif (PMAD), Beaujon Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), University Denis Diderot (Paris VII), 100 boulevard du Général Leclerc, 92110, Clichy, France

    Léon Maggiori M.D., Ph.D. & Yves Panis M.D., Ph.D.

Authors
  1. Léon Maggiori M.D., Ph.D.
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  2. Yves Panis M.D., Ph.D.
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Corresponding author

Correspondence to Yves Panis M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Saint-Pierre University Hospital, Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Brussels, Belgium

    Giovanni Dapri

  2. Minimally Invasive Colorectal Surgery, Lankenau Medical Center, Main Line Healthcare, Wynnewood, Pennsylvania, USA

    John H Marks

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Maggiori, L., Panis, Y. (2018). Single-Port Laparoscopic TME with Low Colorectal Anastomosis. In: Dapri, G., Marks, J. (eds) Surgical Techniques in Rectal Cancer. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55579-7_12

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  • DOI: https://doi.org/10.1007/978-4-431-55579-7_12

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  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-55578-0

  • Online ISBN: 978-4-431-55579-7

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