Abstract
We report our experience of curative colectomy via a transverse mini-incision for locally advanced colonic cancer, with special reference to its techniques, safety, and minimal invasiveness. The subjects were 24 consecutive patients (12 men) with locally advanced colonic cancer who were operated on using a transverse mini-incision (skin incision, 6-7 cm) between April 2009 and December 2010 (Transverse mini-incision group). Their median body mass index (BMI) was 21.6 (range, 14.2-23.9) kg/m2. The pathological stage was stage Ⅰ in 5 patients, stage Ⅱ in 10 patients, and stage Ⅲ in 7 patients. The key points of the surgery included retraction of the rectus abdominis muscle laterally without dissection, adoption of a wound retractor, and a median approach for lymph node dissection. Extension of the wound by 2 cm was needed in one patient and postoperative adhesion ileus requiring relaparotomy developed in one patient. The data of this operative group were compared with the data of 24 patients (control group) who had previously undergone curative colectomy via a longitudinal mini-incision, matched with the patients of the transverse mini-incision group for sex, body mass index ( ± 2kg/m2), tumor location, maximal tumor diameter (±20 mm), histological stage, and level of lymph node dissection. Duration of surgery and blood loss did not significantly differ between the two groups. Postoperative analgesic use was lesser (p < 0.01), passage of flatus was earlier (p = 0.09) and postoperative length of hospital stay was shorter (p = 0.054) in the transverse mini-incision group. These results suggest that curative colectomy via a transverse mini-incision is a safe and minimally invasive procedure for the treatment of locally advanced colonic cancer.
