Cirugía Monopuerto en patología colorrectal: resultados preliminares / Single port access surgery in colorectal disease: preliminary results

Introducción El objetivo del estudio es la evaluación de la técnica monopuerto en patología colorrectal en cuanto su adecuación a criterios oncológicos, fiabilidad, seguridad y reproducibilidad de la técnica. Se realiza un estudio descriptivo y prospectivo de casos describiendo los resultados preliminares de nuestra experiencia. Material y métodos Presentamos una serie de 24 pacientes con patología colorrectal intervenidos mediante abordaje monopuerto con dispositivo Gel point® durante el periodo de tiempo comprendido entre junio y diciembre del año 2010. Se realizaron 9 hemicolectomías derechas, 9 resecciones de sigma, 4 resecciones anteriores altas, 1 hemicolectomía izquierda por tumor de ángulo esplénico y una colectomía subtotal. Resultados El tiempo quirúrgico medio, para el colon derecho, fue de 82,77 min (rango 40-170), de 122,14 min (rango 75-200) para el colon izquierdo y el recto y de 270 min en la colectomía subtotal. La mediana de número de ganglios resecados fue de 22 (rango 3-27) para colon derecho y 21 (rango 11-28) para el colon izquierdo y el recto, la media de longitud de la pieza quirúrgica fue de 20,37cm (rango 16,20-27,50) para el colon derecho y de 24,92cm (rango 14,50-31) para el colon izquierdo y el recto, la mediana de estancia hospitalaria global fue de 6 días (rango 5-13). La morbilidad fue del 8,3% (2 pacientes), uno presentó una oclusión por bridas y otro fuga en la anastomosis. No hubo mortalidad. Conclusiones El abordaje monopuerto es una técnica reproducible y segura, manteniendo criterios oncológicos, en cirujanos habituados a la cirugía colorrectal por vía laparoscópica convencional. Sería necesario un mayor número de casos para la estandarización de la técnica (AU)

Introduction The aim of this study is to evaluate the single port access technique in colorectal disease, as regards its suitability to oncological criteria, reliability, safety and reproducibility of the technique. A descriptive and prospective case study is performed describing the preliminary results of our series. Material and methods We present a series of 24 patients with colorectal disease who underwent single port access surgery using a Gel point ® device between June and December 2010. The operations performed were, 9 right hemicolectomies, 9 sigmoid resections, 4 high anterior resections, 1 left hemicolectomy due to a tumour of the splenic flexure, and 1 sub-total colectomy. Results The mean surgical time for the right colon was 82.8minutes (range 40-170), 122.1minutes (range 75-200) for the left colon and rectum, and 270minutes for the sub-total colectomy. The median number of ganglia resected was 22 (range: 3-27) for the right colon and 21 (range: 11-28) left colon/rectum. The mean length of the surgical specimen was 20.37cm (range: 16.2 – 27.5) for the right colon, and 24.92cm (range: 14.5 – 31) for the left colon/rectum. The median overall hospital stay was 6 days (range: 5-13). Morbidity was 8.3% (2 patients); one with an occlusion due to adhesions, and another with a leak in the anastomosis. There were no deaths. Conclusions The single port access technique is safe and reproducible, maintaining oncological criteria, for surgeons accustomed to colorectal surgery by conventional laparoscopy. A larger number of cases would be required to standardise the technique(AU)

[Single port access surgery in colorectal disease: preliminary results]. / Cirugía Monopuerto en patología colorrectal: resultados preliminares.

INTRODUCTION: The aim of this study is to evaluate the single port access technique in colorectal disease, as regards its suitability to oncological criteria, reliability, safety and reproducibility of the technique. A descriptive and prospective case study is performed describing the preliminary results of our series. MATERIAL AND METHODS: We present a series of 24 patients with colorectal disease who underwent single port access surgery using a Gel point® device between June and December 2010. The operations performed were, 9 right hemicolectomies, 9 sigmoid resections, 4 high anterior resections, 1 left hemicolectomy due to a tumour of the splenic flexure, and 1 sub-total colectomy. RESULTS: The mean surgical time for the right colon was 82.8 minutes (range 40-170), 122.1 minutes (range 75-200) for the left colon and rectum, and 270 minutes for the sub-total colectomy. The median number of ganglia resected was 22 (range: 3-27) for the right colon and 21 (range: 11-28) left colon/rectum. The mean length of the surgical specimen was 20.37 cm (range: 16.2 - 27.5) for the right colon, and 24.92 cm (range: 14.5 - 31) for the left colon/rectum. The median overall hospital stay was 6 days (range: 5-13). Morbidity was 8.3% (2 patients); one with an occlusion due to adhesions, and another with a leak in the anastomosis. There were no deaths. CONCLUSIONS: The single port access technique is safe and reproducible, maintaining oncological criteria, for surgeons accustomed to colorectal surgery by conventional laparoscopy. A larger number of cases would be required to standardise the technique.