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New approaches in laparoscopic surgery for colorectal diseases: The totally laparoscopic and single-incision approaches

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World Journal of Surgical Procedures 2015年第1期5卷 58-64页

作者： Hiroki Akamatsu Masahiro Tanemura kentaro kishi Mitsuyoshi Tei Toru Masuzawa Masaki Wakasugi Department of Surgery Osaka Police Hospital

More than 20 years have passed since the first report of laparoscopic colectomy in 1991. Thereafter, laparoscopic surgery for the management of colorectal diseases has been widely accepted as a prevailing option because of improved cosmetic outcomes, less postoperative pain, and shorter hospital stay in comparison with open surgery. To further the principle of minimally invasive surgery, two new approaches have been developed in this rapidly evolving field. The first is the totally laparoscopic approach. Currently most of standard techniques inevitably involve an abdominalincision for retrieval of the specimen and preparation for anastomosis, which might compromise the benefits of laparoscopic surgery. The totally laparoscopic approach dispenses with this incision by combining completely intraperitoneal anastomosis with retrieval of the specimen via a natural orifice, such as the anus or the vagina. Our new and reliable technique for intraperitoneal anastomosis is also described in detail in this article. The second is the single-incision approach. While three to six ports are needed in standard laparoscopic surgery, the single-incision approach uses the umbilicus as the sole access to the abdominal cavity. All of the laparoscopic procedures are performed entirely through the umbilicus, in which the surgical scar eventually becomes hidden, achieving virtually scarless surgery. This article reviews the current status of these two approaches and discusses the future of minimally invasive surgery for colorectal diseases.

关键词： Totally laparoscopic surgery Minimally invasive surgery Single-incision laparoscopic surgery Natural orifice transluminal endoscopic surgery Natural orifice specimen extraction

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Efficacy of subcutaneous penrose drains for surgical site infections in colorectal surgery

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World Journal of Gastrointestinal Surgery 2013年第4期5卷 110-114页

作者： Shinya Imada Shingo Noura Masayuki Ohue Tatsushi Shingai Toshinori Sueda kentaro kishi Terumasa Yamada Hiroaki Ohigashi Masahiko Yano Osamu Ishikawa Department of Surgery Osaka Medical Center for Cancer and Cardiovascular Diseases

AIM: To investigate whether a subcutaneous penrose drain would decrease the superficial surgical site infection (s-SSI) rate in elective colorectal surgery. METHODS: This is a comparative study of the historical control type. Intervention consisted of the use of penrose drain in elective open colorectal surgical wounds. The outcome was an incidence of s-SSI. The patients were risk stratified according to the depth of subcutaneous ***: There were 131 patients (40 patients with high s-SSI risk) in the prior period (from July 2008 to June 2009, when no penrose drains were inserted) and 151 patients (75 patients with high s-SSI risk) in the latter period (from June 2010 to November 2011, when penrose drains were inserted). The overall s-SSI rate was 6.1% and 5.3% during the two periods (P = 0.770), and the s-SSI rate in the high s-SSI risk group was 15.0% and 8.0% (P = 0.242).CONCLUSION: Although penrose drain was not observed to significantly reduce s-SSI, there tended to be a reduced risk of s-SSI in the high s-SSI risk group.

关键词： Surgical site infections Subcutaneous penrose drains Colorectal surgery Open surgery Subcutaneous tissue

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Solitary mediastinal lymph node recurrence after curative resection of colon cancer

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World Journal of Gastrointestinal Surgery 2014年第8期6卷 164-168页

作者： Yasuhiro Matsuda Masahiko Yano Norikatsu Miyoshi Shingo Noura Masayuki Ohue Keijiro Sugimura Masaaki Motoori kentaro kishi Yoshiyuki Fujiwara Kunihito Gotoh Shigeru Marubashi Hirofumi Akita Hidenori Takahashi Masato Sakon Department of Surgery Osaka Medical Center for Cancer and Cardiovascular Disease

We report two cases of solitary mediastinal lymph node recurrence after colon cancer resection. Both cases had para-aortic lymph node metastasis at the time of initial surgery and received adjuvant chemotherapy for 4 years in case 1 and 18 mo in case 2. The time to recurrence was more than 8 years in both cases. After resection of the recurrent tumor, the patient is doing well with no recurrence for 6 years in case 1 and 4 mo in case 2. Patients should be followed up after colon cancer surgery considering the possibility of solitary mediastinal lymph node recurrence if they had para-aortic node metastasis at the time of initial surgery.

关键词： Solitary mediastinal lymph node recurrence Colon cance

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