Single incision laparoscopic right hemicolectomy: different approaches.

BACKGROUND: Single incision laparoscopic colectomy has been performed in recent years, and has been shown to be feasible and safe. This study was to assess the feasibility of single incision laparoscopic right hemicolectomy and to compare the differences in different approaches. METHODS: This retrospective study included eighteen patients with carcinoma of caecum and ascending colon, undergoing single incision laparoscopic right hemicolectomy. This study also compared single incision laparoscopic right hemicolectomy using different approaches: (1) single incision multiport, (2) single access port and (3) glove port. RESULTS: There was no statistical difference in surgical outcomes. Concerning the surgeon's satisfaction toward three methods, overcrowding and durability were similar but the single incision multiport was associated with the highest gas-leak and the "glove" port was associated with poor durability. However, the method of single incision multiport has the lowest average cost of the special trocar or port in each operation. The operative time and blood loss of the operations in this study were comparable to previous publications. CONCLUSION: There was no significant difference between different approaches of single incision laparoscopic right hemicolectomy for colonic cancer in right side colon.

Novel "glove" access port for single port surgery in right hemicolectomy: a pilot study.

The trend of single port surgery is increasing recently, and it is technically feasible for right hemicolectomy. However, the operation requires special and expensive access port for the insertion of the instruments. Day et al reported the use of a novel "glove" access port for right hemicolectomy in this pilot study. Four single port right hemicolectomies were performed by using this access port. The access port was found to be user-friendly and durable. No adverse outcome was associated with this access port. This "glove" access port is a suitable device for single port right hemicolectomy.

Primary colorectal lymphoma: case series and literature review.

Primary colorectal lymphoma is a rare disease that accounts for 0.16% of colorectal malignancies. Treatments include surgical intervention with or without chemotherapy. Outcome of this intervention among the Chinese population are lacking. Perforation resulting from chemotherapy may need further exploration. A retrospective review of patient records was performed among those who were diagnosed with colorectal malignancy in a single center from January 1998 to June 2009. Ten patients met Dawson's diagnostic criteria for primary colorectal lymphoma [0.66% (10/1516) of all colorectal malignancies]. The male-to-female ratio was 9:1, and median age at diagnosis was 76 years. The most common site was the cecum (n = 5). B-cell lymphoma was present in eight patients. Seven patients underwent surgical intervention. The median follow-up of all patients was 16.5 months. Median survival was 17 months and 13 months in the surgical and chemotherapy group, respectively. Primary colonic lymphoma is a rare disease. Surgical intervention appeared to be superior to chemotherapy alone, but the findings were limited by the small number of patients in this study. Whether surgery or chemotherapy should be offered first remains unknown and requires further research.

Use of laparoscopic deployable vascular clamp for bowel control in on-table colonoscopy during laparoscopic colectomy.

Author described the alternative use of a laparoscopic deployable vascular clamp for bowel control during on-table colonoscopy in laparoscopic colorectal surgery.

Is it safe to perform operation for colorectal malignancy in Chinese patients without DVT prophylaxis? An 8-year experience from a regional hospital in Hong Kong / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Colorectal surgery was regarded as one of the high risk surgery for post-operative deep vein thrombosis (DVT) and pulmonary embolism. This study aimed at investigating the incidence of venous thromboembolism (VTE) after colorectal surgery for malignancy.</p><p><b>METHODS</b>Data were collected from the prospective database of colorectal malignancy from 2000 to 2008. A total of 1421 colorectal (open and laparoscopic) operations were performed for the colorectal malignancy without DVT prophylaxis.</p><p><b>RESULTS</b>Only seven patients (0.5%) developed symptomatic DVT and one of them had complication of pulmonary embolism without mortality. Open operation for colorectal malignancy was identified as possible risk factor of DVT, however, risk factors like operative time, low anterior resection, sex, age etc. were not identified.</p><p><b>CONCLUSION</b>Risk of venous thromboembolism after colorectal operation is low in Chinese of our locality and it might be safe to perform colorectal operation for malignancy without DVT prophylaxis.</p>

Comparison of TPS with CEA and CA 15.3 in follow-up of Chinese breast cancer patients.

Serum levels of serum tissue polypeptide specific antigen (TPS) were compared with levels of carcinoembryonic antigen (CEA) and CA 15.3 with regards to their clinical values in Chinese breast cancer patients. A total of 81 patients were recruited and followed-up prospectively for disease recurrence and death. The median of follow-up was 33.1 months. CEA and CA15.3 correlated with the prognostic factors associated with poor prognosis. CA15.3 was associated with disease-free survival and overall survival. Multivariate analyses showed that the pre-operational serum CA15.3 level was an independent prognostic factor for disease-free survival. However, TPS was associated with neither prognostic factors nor patient survival. In conclusion, TPS is not a good serum tumor marker for breast cancer of Chinese patients, compared with CEA and CA 15.3.