Curative Resection of Transverse Colon Cancer via Minilaparotomy

Abstract

Minilaparotomy has been reported to be a minimally invasive alternative to laparoscopically assisted surgery. We retrospectively evaluated the usefulness of minilaparotomy for the resection of transverse colon cancer, which has generally been considered difficult to resect laparoscopically. Patients for whom curative resection was attempted for transverse colon cancer (n = 21) or sigmoid colon cancer (n = 81) via minilaparotomy (skin incision, , _ 7cm) were analyzed. The 2 groups did not significantly differ in terms of success rate of minilaparotomy (90.5% versus 97.5%), age, sex, pathologic stage, body mass index, operative time (mean, 133.5 minutes versus 122.5 minutes), blood loss (119.7 mL versus 92.4 mL), number of lymph nodes harvested, incidence of postoperative complications (9.5% versus 12.3%), postoperative length of stay, and 5-year disease-free survival rate (86.6% versus 79.6%). Minilaparotomy is feasible, safe, and favorable in terms of early oncologic outcome in patients with transverse colon cancer as well as those with sigmoid colon cancer.

Comparison Between Transverse Mini-Incision and Longitudinal Mini-Incision for the Resection of Locally Advanced Colonic Cancer

“…Thus, this approach seems to be acceptable if surgeons are familiar with a longitudinal mini-incision. [1][2][3][4][5][11][12][13][14][15] There may be a criticism regarding surgeons' experiences on the 2 study periods of different procedures. All the procedures throughout the 2 study periods were exclusively managed by the board-certified surgeons.…”

“…All the surgical procedures via the transverse mini-incision were the same as those via the longitudinal mini-incision reported elsewhere, [1][2][3][4][5] except for the method of exposing the abdominal cavity. Each patient was positioned supine.…”

“…A s a useful alternative to laparoscopic-assisted surgery, we have performed a longitudinal mini-incision (skin incision, ,7 cm) for the resection of locally advanced colonic cancer in non-overweight (body mass index ,25.0 kg/m 2 ) patients since 2000 and have demonstrated satisfactory outcomes in terms of technical feasibility and safety, minimal invasiveness, and oncological safety. [1][2][3][4][5] The ''longitudinal short'' or ''transverse'' incision has been proposed as part of an enhanced recovery after surgery (ERAS) clinical care protocol, 6 which was developed firstly and mainly for open colectomies. The use of such incision types is considered to reduce postoperative pain, leading to a more rapid return of patient mobility.…”

Oncologic Outcome of Stages II/III Colon Cancer Treated via Minilaparotomy

“…Although we had not specifically considered this factor, performing colectomy by minilaparotomy approach on transverse colon cancer did not pose any technical difficulties compared with that for tumors at other locations. 15 Many reports [16][17][18] described that the conversion rate was reported to be relatively high in laparoscopic-assisted colectomy because of high BMI, although several researchers 19,20 claimed that obesity did not have an adverse impact on the technical difficulties in laparoscopic techniques. Except for the tumors of midsigmoid and midtranverse colon, we have also limited the selection of patients to nonoverweight persons (BMI , 25.0 kg/m 2 ).…”