Short‐ and long‐term outcomes of single‐incision laparoscopic surgery for right colon cancer: A multicenter propensity score‐matched analysis

Abstract

Introduction Single‐incision laparoscopic surgery (SILS) for colon cancer is a recent innovation in minimally invasive surgery that can improve short‐term outcome. However, several biases exist in current favorable comparisons of SILS with conventional laparoscopic (CL) surgery. Moreover, the oncological outcomes in SILS remain unclear. The aim of this study was to identify outcomes following SILS and CL for right colectomy using a propensity score‐matched analysis. Methods A total of 553 patients underwent curative resection for right colon cancer (58 SILS and 495 CL). After propensity score matching, 58 patients in each group were matched. Results Before matching, median age was younger (p = 0.037) and clinical stage was lower (p < 0.001) in the SILS group. After matching, operation time was shorter (172 versus 193 min, p = 0.007) and blood loss was less (12 versus 20 mL, p = 0.037) in the SILS group. Most of the SILS cases were performed (43.1%) or supervised (51.7%) by an expert surgeon. Median follow‐up duration was 30 and 37 mo in the SILS and CL groups, respectively. Three‐year relapse‐free survival was 92.5% and 92.4% (p = 0.781); and overall survival was 100% versus 98.1% (p = 0.177). Conclusions Under the control of expert surgeons, SILS appeared to be a safe and feasible approach and had similar oncological outcomes compared with CL in a propensity score‐matched cohort of patients with right‐sided colon cancer.

D3 lymph node dissection with versus without left colic artery preservation in single‐incision laparoscopic surgery for sigmoid and rectosigmoid cancer: A propensity score‐matched analysis

“…Furthermore, SILS reportedly achieves a better cosmetic effect and less postoperative pain than conventional multiport laparoscopic surgery for ascending colon cancer, sigmoid colon cancer, and rectosigmoid cancer 17 . Although right hemicolectomy requires a lot of vascular treatment, SILS reportedly has a shorter operative time than conventional laparoscopic surgery 18,19 . Therefore, it seems that even complicated procedures such as LCA preservation can be performed via SILS.…”

“…17 Although right hemicolectomy requires a lot of vascular treatment, SILS reportedly has a shorter operative time than conventional laparoscopic surgery. 18,19 Therefore, it seems that even complicated procedures such as LCA preservation can be performed via SILS.…”

A first report of right-hemicolectomy for ascending colon cancer in Japan with the da Vinci SP surgical robot system

“…In Japan, a prospective cohort study on robotic surgery for colon cancer demonstrated the safety and curative potential of the surgical system [ 3 ]. The world's first minimally invasive single-incision laparoscopic surgery (SLS) was reported in 2008 [ 4 ], and many studies have shown its safety and favorable oncologic outcomes compared with those of multiport laparoscopic surgery [ 5 – 8 ]. The da Vinci SP system (Intuitive Surgical Inc., Sunnyvale, CA, USA) is a specialized surgical platform that enables single-port robot-assisted surgery.…”