FACO Surgery Session
Short-term outcomes of a total laparoscopic colectomy (TLC) for right side colon cancer with intra-corporeal anastomosis
演題番号 : FSS9-1
1:Department of Surgical Oncology, Dokkyo Medical University
The standard method of laparoscopic colectomy consists of intra-corporeal mobilization, lymphadenectomy, and extra-corporeal intestinal anastomosis, for which a large incision is necessary. Here, we report a method and short-term outcomes of total laparoscopic colectomy (TLC) for the right side with intra-corporeal anastomosis.
Patients and Methods
From 2000 to 2014, a right side colectomy was performed on 416 patients. Among them, 68 patients received a laparoscopy assisted colectomy. A TLC was performed on 14 patients who were enrolled in this study. The duration of the operation, amount of bleeding, duration of anastomosis, frequency of anastomotic leakage, and frequency of surgical site infection were examined.
TLC procedures were done through five trapezoidally arranged ports. A 12mm port was used in the left upper abdomen because the insertion of a linear stapler was necessary. Mobilization, lymphadenectomy, and intestinal dividing were done intra-corporeally. Before the anastomosis, a resected specimen was retrieved to the extra abdomen through a minimal incision. The ileum and colon were overlapped to a length of 10cm. Then, a small entry hall was opened in the ileum in the resected stump. Another small hall was opened in the colon 10cm from the resected stump. Side to side anastomosis between the ileum and colon was completed with a 60mm linear stapler. The entry hall of the linear stapler was closed by manual continuous suture.
The duration of the operation was 207 minutes. The amount of bleeding was 20 ml. The duration of the anastomosis was 35 minutes. There were no anastomotic leakages or surgical site infections. With a follow-up colonoscopy, anastomosis was enough to pass intestinal flow, and there was no evidence of stricture.
TLC for the right side of the colon is a safe procedure. Because of the small incision and less mobilization of the intestine, the procedure is a less invasive method.