title: Adequate margins for anorectal cancer can be achieved by single-site laparoscopy.
abstract: BACKGROUND
  To assess both the adequacy of surgical resection and the short-term postoperative outcomes for patients undergoing single-site laparoscopy (SSL) surgery involving low anterior resection (LAR) and abdominoperineal resection (APR) for malignancies.
  
  
  METHODS
  Consecutive rectal and anal cancer patients who underwent SSL LAR and APR were studied. Use of neoadjuvant therapy, operative details, and 30-day complications were sought. Radial and distal margins of resection and the pathologist's evaluation of the mesorectum were analyzed.
  
  
  RESULTS
  Twelve patients (median age, 66 years) were identified; 11 (91%) were diagnosed with rectal adenocarcinoma and 1 (9%) with anal melanoma. Median location of the cancers was 5 cm from the anal verge, with 6 (55%) patients receiving neoadjuvant chemoradiation. Seven (58%) patients underwent an LAR, 2 of whom were also given a diverting ileostomy at surgery. Median body mass index was 28 kg/m(2) (range, 24-36 kg/m(2)). All resection margins were clear of tumor by histology, with the majority of patients having T3 (41%), N0 (58%) cancers. Median node yield was 18 nodes. The median distal margin was 3 cm, with a median radial margin of 6 mm. All specimens had an intact mesorectum.
  
  
  CONCLUSIONS
  SSL resections for rectal and anal cancers can achieve adequate resection margins. Larger prospective studies are needed to validate oncologic outcomes for SSL.
authors: Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA. dstewart@hmc.psu.edu
authors: David B
authors: DB
authors: Stewart
authors: Evangelos
authors: E
authors: Messaris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies