New ports placement in laparoscopic central lymph nodes dissection with left colic artery preservation for sigmoid colon and rectal cancer

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  • Higashijima Jun
    Department of Digestive and Pediatric Surgery Tokushima University Hospital
  • Shimada Mitsuo
    Department of Digestive and Pediatric Surgery Tokushima University Hospital
  • Iwata Takashi
    Department of Digestive and Pediatric Surgery Tokushima University Hospital
  • Yoshikawa Kozo
    Department of Digestive and Pediatric Surgery Tokushima University Hospital
  • Nakao Toshihiro
    Department of Digestive and Pediatric Surgery Tokushima University Hospital
  • Nishi Masaaki
    Department of Digestive and Pediatric Surgery Tokushima University Hospital
  • Kashihara Hideya
    Department of Digestive and Pediatric Surgery Tokushima University Hospital
  • Takasu Chie
    Department of Digestive and Pediatric Surgery Tokushima University Hospital

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Abstract

Background: Lymph nodes (LNs) dissection around inferior mesenteric artery (IMA) with left colic artery (LCA) preservation is difficult due to the anatomical feature of IMA. The aim of this study is to evaluate the usefulness of new ports placement inserted from a suprapubic region in laparoscopic LNs dissection around IMA with LCA preservation for sigmoid colon and ractal cancer. Methods: Twenty-two patients who underwent laparoscopic colectomy for sigmoid colon and recal cancer were included. The new ports placement group (n=15, new group) was compared with the basic ports placement group (n=7, basic group). Average number of harvested LNs, total operation time, central LNs dissection time, intraoperative blood loss were compared. Results: There was no significant difference in the average number of harvested LNs. The mean of intraoperative blood loss of new group was significantly lower than that of the basic group (40.0±39.8 ml vs 95.7±81.0 ml, p<0.05). In addition, the mean of operation time of the new group was significantly shorter than that of the basic group (250.0±55.7 min vs 353.4±80.2 min, p<0.05). Conclusions: The new ports placement is useful in laparoscopic LNs dissection around IMA with LCA preservation for sigmoid colon and rectal cancer. J. Med. Invest. 62: 223-227, August, 2015

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