Purpose: Analysis about disease, technical characteristics of 17 right colon cancer patients underwent conversion to laparotomy from single port laparoscopic surgery and propose related factors for indications. Methold: Consist of 17 colon cancer patients, who were conversion to laparotomy from single port laparoscopic colectomy at Hue Central Hospital from october 2010 to august 2014. Results: Mean age 61.3±14.2 years, rate male/female 11/6. Tumor invasion: T2 11.8%, T3 58.8%, T4 29.4%. Mean tumor size on CT 6.5±2.2cm. The causes of conversion: very big tumors 29.4%, invasive-adhesive tumors 47.1%, extended surgery 23.5%. Open procedures: right hemicolectomy 70.6%, right hemicolectomy plus cholecystectomy 5.9%, right hemicolectomy plus wedge-shape duodenectomy 11.8%, right hemicolectomy plus intestinal segmentectomy 5.9% and right hemicolectomy plus low-anterior rectal resection, hysterectomy 5.9%. Conclusion: Conversion to laparotomy from single port laparoscopic colectomy is necessary for very big tumors, excessive tumor adhesions and exceed the technical limitations of laparoscopic dissection. Key words: Single incision laparoscopic colectomy (SILC), single port laparoscopic colectomy (SILC), conversion to laparotomy.

This study aimed to evaluate the feasibility, safety and early results of this technique. Materials and methods Materials: 114 colon cancer cases confirmed by preoperative colonoscopic biopsy. All tumors were ≤8 cm, stage III or under, non-invasive to adjacent organs, with no distant metastasis on CT-scan. Patients were ASA 1-3. Methods: Prospective study: general characteristics of patients, surgical procedures, conversion rate, complications during and after surgery, the results of surgery, and hospital stays were collected for analysis.

Perpose: Evaluation of clinic, subclinic characteristics and results from laparoscopic left hemicolectomy for left colon cancer at Hue Central Hospital. Metholds: Consist of 45 patients with left colon cancer who were operated to laparoscopic left hemicolectomy, sigmoidectomy and lymphadectomy at Hue Centre Hospital from september 2007 to september 2010. Results: Age: average 57,2 ± 16,8, the most age range from 40 - 60, to take 51,1%. Sex: male 62,2%, female 37,8%, rate male/female 1,65/1. The most symptom was abdominal pain 93,3%, alimentary disorder 31,1%, blood stool 53,3%, touch up the tumors 13,3%. Colonoscopy: malignant ulcer tumors were highest rate 42,2%, tumor positions at sigmoid colon 60,9%. Laparoscopic sigmoidectomy 62,2%, left hemicolectomy 17,8%, size of the tumor upper 5 cm was 60,8%. Third stage of TNM 64,4% and adenocarcinoma was 97,8%. Elevation of CEA serum level upper 5ng/ml: Preoperative was 57,8%, postoperative of three months was 25,8%, postoperative of six months was 33,3%. Wound infection was 4,4%, anastomotic leakage 2,2%, and without reoperative case and without surgical mortality. Conclusions: Laparoscopic left hemicolectomy for left colon cancer is safe, feasible, few complications and its advantages.

Background: The role of laparoscopic resection in the management of colon cancer is still controversial. We prospectively evaluated technical profile and outcomes in patients undergoing laparoscopic resection for colon cancer at a single institution. Methods: From January 2009 to June 2010, patients with colon cancer were treated by laparoscopy at Hue Central Hospital. Results: Mean operating time was 175 minutes. Conversion to open surgery was required in 6 of 40 patients (15percent). There was no per-operative complication. There was no postoperative mortality. Post-operative complications were one anastomotic leakage, one early intestinal obstruction and two wound infections. Mean hospital stay was 11 days (range, 7-26). There was no local recurrence and no port site metastases at 6 months after the surgery Conclusions: Laparoscopic colon surgery is feasible and safe but also technically demanding (conversion rate of 15 percent), time-consuming (mean operating time, 175 minutes). Authors should have a longer follow-up to fully assess the oncologic outcome in this group of patients. At present, the technique should only be performed in specialist centers by teams experienced in laparoscopic surgery.

Tóm tắt Mục tiêu: Đánh giá kết quả phẫu thuật nội soi một cổng (PTNSMC) ung thư đại tràng có theo dõi và đánh giá kết quả sống còn sau mổ. Đối tượng nghiên cứu: Nghiên cứu tiến cứu gồm 114 người bệnh (NB) ung thư đại tràng (UTĐT) được phẫu thuật nội soi một cổng từ tháng 12/2011 được theo dõi đến tháng 12/2018 tại Bệnh viện Trung ương Huế. Kết quả: Tuổi trung bình (TB) 57,1 ± 14,2 tuổi (25 - 87), tỷ lệ nam/nữ 1,6/1, tăng CEA trước mổ 54,4%, kích thước u TB 4,9 ± 2,5cm (1 - 7,5). Phương pháp phẫu thuật: cắt nửa đại tràng phải 73,7%, cắt nửa đại tràng trái 14,9%, cắt đoạn đại tràng sigma 11,4%, đặt thêm 1 trocar hỗ trợ 16,7%, không có tử vong cũng như các tai biến trong mổ. Thời gian phẫu thuật 163,5 ± 75,5 phút (120 - 290), số hạch thu được 16,2 ± 4,5 hạch (12 - 25), thời gian nằm viện 7,5 ± 6,1 ngày (6 - 15). Giai đoạn (GĐ): GĐ1: 30,7%; GĐ2: 43,9%; GĐ3: 25,4%. Thời gian theo dõi 38,2 ± 17,5 tháng (6 - 84), 5 NB tái phát tại vùng 4,4%, 3 NB tiến triển di căn xa 2,6%. Sống còn toàn bộ sau 2 năm 96,2%, sau 5 năm 75,7%, sống còn 5 năm theo giai đoạn: GĐ1: 90,9%; GĐ2: 71,6%; GĐ3: 20,8% (p< 0,0001). Kết luận: Phẫu thuật nội soi một cổng ung thư đại tràng là khả thi và an toàn, giá trị thẩm mỹ là vết rạch ngắn, được che phủ bởi rốn. Kết quả lâu dài về mặt ung thư học là tương tự với phẫu thuật nội soi truyền thống trong ung thư đại tràng. Abstract Objectives: Evaluation of results of single port laparoscopic surgery (SPLS) for colon cancer with follow up of survival. Materials and methods: Prospective study of 114 patients suffering from colon cancer underwent SPLS from December 2011, were followed up until December 2018 at Hue Central Hospital. Results: Average age was 57.1 ± 14.2 years (25 - 87), male/female was 1.6/1, pre-operative elevated level of CEA was 54.4%, average tumor size 4.9 ± 2.5cm (1 - 7.5). Surgical techniques included right hemicolectomy 73.7%, left hemicolectomy 14.9% and sigmoidectomy 11.4%, additional one more trocar was 16.7%. No death and nor complications were observed during surgery. Time of surgery was 163.5 ± 75.5 minutes (120 - 290), mean lymph nodes harvest 16.2 ± 4.5 nodes (12 - 25), mean hospital lenght stay was 7.5 ± 6.1 days (6 - 15). Stage I: 30.7%; stage II: 43.9%; stage III: 25.4%. Follow-up time was 38.2 ± 17.5 months (6 - 84), local recurrence was in 5 patients accounted for 4.4%, 3 patients with distal metastasis 2.6%, overall survival rates after 2 years accounted for 96.2%, after 5 years in 75.7%, 5 years of survival according to stage were : stage I in 90.9%, stage II in 71.6%, stage III in 20.8% (p <0, 0001). Conclusion: Single port laparoscopic surgery for colon cancer is feasible and safe, cosmetic aspect is a short incision, hidden by the umbilicus. Long-term results in oncology are equivalent to conventional laparoscopic surgery. Keywords: Colon cancer, Single port laparoscopic surgery.