Safety and feasibility of single-port laparoscopic low anterior resection for upper rectal cancer

• Published in: The American journal of surgery Vol. 216; no. 6; pp. 1101 - 1106
• Main Authors: Tei, Mitsuyoshi, Otsuka, Masahisa, Suzuki, Yozo, Kishi, Kentaro, Tanemura, Masahiro, Akamatsu, Hiroki
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2018
• Subjects: Low anterior resection; Rectal cancer; Single-incision laparoscopic surgery; Single-port surgery; Single-port surgery; Low anterior resection; Rectal cancer; Single-incision laparoscopic surgery
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2018.03.022

Single-port surgery for rectal cancer is challenging and controversial. The aim of this study was to compare the short-term outcomes of single-port laparoscopic low anterior resection (S-LAR) to multi-port laparoscopic low anterior resection (M-LAR) for upper rectal cancer. From January 2011 to December 2015, a total of 93 patients who underwent S-LAR (n = 44) or M-LAR (n = 49) without protective diverting ileostomy for upper rectal cancer were identified. Tumors were located between the inferior margin of the second sacral vertebra and the peritoneal reflection. Short-term outcomes were compared between groups. S-LAR was successful in 75% of cases: 25% of cases required one additional port. Operative factors, perioperative outcomes, oncological outcomes did not differ significantly between groups. In patients with stage I-III disease, the 3-year relapse-free survival rate was significantly higher in the S-LAR group than in the M-LAR group (p = 0.032). The 3-year overall survival rate was similar between groups. S-LAR is safe, feasible and can provide satisfactory oncological outcomes in selected patients with upper rectal cancer. •We assess the safety and feasibility of S-LAR for upper rectal cancer.•Short-term and long-term oncological outcomes did not differ significantly between S-LAR and M-LAR group.•S-LAR is safe, feasible and can provide satisfactory oncological outcomes in selected patients with upper rectal cancer.