Single-Incision Laparoscopic Colostomy or Ileostomy for Unresectable Colorectal Cancer

Abstract

We applied colostomy or ileostomy using single-incision laparoscopic surgery (SILS) in patients with unresectable colorectal cancer, and evaluated SILS based on our experience.
The subjects were 18 patients who underwent single-incision laparoscopic colostomy or ileostomy. Before surgery, the part of the intestinal tract for the stomal site and the application sites was decided. In the procedure, we used a circular incision for a single port. After the intra-abdominal observation, we could confirm peritoneal metastasis, direct invasion, and make a cytological examination of ascites. Dissection and mobilization were applied if necessary.
Stoma was applied in 15 colostomies and 3 ileostomies. We could confirm peritoneal or omental metastasis in 6 patients. Another 4 patients were diagnosed with peritoneal metastasis by laparoscopic examination. We also performed examination of ascites in 9 patients. In three of them, carcinoma cells were found. In addition, in 7 patients, an adhesion was dissected and the intestine was mobilized.
Single-incision laparoscopic colostomy and ileostomy facilitate postoperative stoma management because there is no scarring without a stoma. In addition, they enable accurate colorectal cancer staging and dissection of adhesion and mobilization of the intestine, which are also marked advantages.