Needlescopic versus conventional laparoscopic surgery for colorectal cancer ~a comparative study~

Objectives: This study set out to determine whether Needlescopic surgery (NS) produces comparable surgical outcomes for patients with colorectal cancer (CRC) compared to conventional multi-port laparoscopic surgery (MPS). Methods: We used the five-port method with a 3.5 cm umbilical incision for extraction and reconstruction during MPS for CRC. One or two 5 mm ports were exchanged for needle forceps and all surgical procedures were as for previous MPS since July 2012. We investigated the short-term outcomes of 138 consecutive patients who underwent curative resection of CRC by NS (July 2012-August 2014) and 130 consecutive patients with CRC treated with MPS during a previous period (January 2010-June 2012). Results: Operative time in the NS group was comparable to that of MPS (p=0.467); the NS group had significantly less estimated blood loss (p=0.002) and a shorter postoperative hospital stay (p<0.001). The mean number of dissected lymph nodes was 27 in both groups (p=0.730). No mortality occurred in either group, and similar morbidity rates were observed (p=0.454). Conclusions: NS using Endo Relief needle forceps is a safe and feasible option compared to conventional MPS for CRC.

[1]  J. Yu,et al.  A safety study of transumbilical single incision versus conventional laparoscopic surgery for colorectal cancer: study protocol for a randomized controlled trial , 2015, Trials.

[2]  G. Marks,et al.  Single-port laparoscopic colorectal surgery shows equivalent or better outcomes to standard laparoscopic surgery: results of a 190-patient, 7-criterion case-match study , 2015, Surgical Endoscopy.

[3]  S. Nagayama,et al.  Needlescopic surgery for left-sided colorectal cancer , 2014, International Journal of Colorectal Disease.

[4]  P. Sylla,et al.  Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES) , 2014, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society.

[5]  H. Cheung,et al.  Advances in laparoscopic colorectal surgery: A review on NOTES and transanal extraction of specimen , 2014, Asian journal of endoscopic surgery.

[6]  F. Konishi,et al.  Oncological 3-Port Laparoscopic Colectomy by 1 Surgeon and 1 Camera Operator: A Preliminary Report , 2013, Surgical laparoscopy, endoscopy & percutaneous techniques.

[7]  G. Grosso,et al.  Laparoscopic-assisted versus open surgery for colorectal cancer: short- and long-term outcomes comparison. , 2013, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[8]  H. Mufty,et al.  Single‐incision right hemicolectomy for malignancy: a feasible technique with standard laparoscopic instrumentation , 2012, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[9]  R. Cahill,et al.  Implementation and usefulness of single‐access laparoscopic segmental and total colectomy , 2012, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[10]  G. Currò,et al.  Single-incision versus three-port conventional laparoscopic right hemicolectomy: is there any real need to go single? , 2012, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[11]  I. Endo,et al.  Single-incision laparoscopic surgery using colon-lifting technique for colorectal cancer: a matched case–control comparison with standard multiport laparoscopic surgery in terms of short-term results and access instrument cost , 2012, Surgical Endoscopy.

[12]  J. Milsom,et al.  Feasibility and Safety of Single-Incision Laparoscopic Colectomy: A Systematic Review , 2012, Annals of surgery.

[13]  W. Chambers,et al.  Single‐incision laparoscopic surgery (SILS) in complex colorectal surgery: a technique offering potential and not just cosmesis , 2011, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[14]  Philip Quirke,et al.  Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial , 2005, The Lancet.

[15]  Marco Braga,et al.  Laparoscopic Versus Open Colorectal Surgery: A Randomized Trial on Short-Term Outcome , 2002, Annals of surgery.

[16]  C. Schlachta,et al.  “Needlescopic” sigmoid resection , 2002, Surgical Endoscopy.

[17]  D. Sargent,et al.  Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. , 2002, JAMA.

[18]  A. Arifi,et al.  'Needlescopic' video-assisted thoracic surgery for palmar hyperhidrosis. , 2000, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[19]  G. Ferzli,et al.  Needlescopic extraperitoneal repair of inguinal hernias , 1999, Surgical Endoscopy.

[20]  I. Gill,et al.  Needlescopic urology: incorporating 2-mm instruments in laparoscopic surgery. , 1998, Urology.

[21]  A. García-Ruiz,et al.  Technical aspects of minimally invasive abdominal surgery performed with needlescopic instruments. , 1998, Surgical laparoscopy & endoscopy.

[22]  S. Seslar,et al.  Needlescopic appendectomy , 2002, Surgical Endoscopy And Other Interventional Techniques.

[23]  E C Poulin,et al.  Needlescopic surgery. A logical evolution from conventional laparoscopic surgery. , 2001, Surgical endoscopy.