title: Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer.
abstract: BACKGROUND
  Recently, laparoscopic colorectal surgery using a single incision usually made at the umbilical area has emerged as a tool to minimize the numbers of scars and provide better cosmetic results. But experience in laparoscopic skills is needed to maintain the oncologic principles of colorectal cancer surgery with the restricted operating field during the procedure. Adding an additional port to single-incision laparoscopic colorectal surgery (SILS) may be a bridge between conventional multiport laparoscopic surgery and SILS. The present study was undertaken to investigate whether umbilical incision laparoscopic colorectal cancer surgery with one additional port (ULAP) could be performed in a similar manner to conventional multiport surgery.
  
  
  METHODS
  One hundred and sixty-three patients with colorectal adenocarcinoma underwent laparoscopic colectomy between February 2011 and August 2011. Forty of these patients underwent ULAP and were compared with the other 123 patients who had conventional laparoscopic surgery. Demographic, intraoperative, and postoperative data were analyzed.
  
  
  RESULTS
  Both groups were similar in age (p = 0.438), gender (p = 0.818), body mass index (p = 0.149), American Society of Anesthesiologists (ASA) scores (p = 0.417), history of previous abdominal operation (p = 0.503), and tumor location (p = 0.051). Operation time was longer in the ULAP group (255.5 min) than in the conventional laparoscopic surgery group (144.6 min) (p < 0.001). No significant differences were evident between groups for estimated blood loss (p = 0.263), transfusion requirements (p = 0.841), conversion to open procedures (p = 0.40), length of umbilical incisions (4.6 vs. 4.4 cm, p = 0.628), postoperative hospital stay (p = 0.862), tumor size (p = 0.455), number of harvested lymph nodes (p = 0.203), proximal margins (p = 0.189), and distal resection margins (p = 0.151). Postoperative morbidity (p = 0.736) was similar in both groups. There was no mortality postoperatively.
  
  
  CONCLUSIONS
  Umbilical incision laparoscopic colorectal cancer surgery with an additional port is a feasible and safe approach, although it is more time consuming than conventional laparoscopic colectomy.
authors.affiliation: Department of Colon and Rectal Surgery, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Gwangju, Hwasun-gun, Jeollanam-do, 519-763, South Korea.
authors.forename: S Woo
authors.initials: SW
authors.lastname: Lim
authors.forename: H Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: C Hyun
authors.initials: CH
authors.lastname: Kim
authors.forename: J Wook
authors.initials: JW
authors.lastname: Huh
authors.forename: Y Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: H Rok
authors.initials: HR
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*; D014472:Umbilicus