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Lymph node harvest in single incision laparoscopic surgery for colorectal malignancy
A D Rink1, B Vestweber, C Paul
1Department of General Surgery, Leverkusen General Hospital, Leverkusen, Germany.
Aim:
Single incision laparoscopic surgery (SILS) has not been sufficiently evaluated with respect to its oncological equivalence to conventional laparoscopic or open surgery.
Method:
Of 507 patients who had SILS for colorectal diseases in our institution, 87 had segmental resection for colorectal adenocarcinoma. For each of the surgical specimens the number of lymph nodes which can be expected to be identified by the pathologist was calculated using the ACPGBI lymph node harvest model, which was developed from a nationwide database of 5845 surgical specimens. The predicted number of lymph nodes was compared with the number identified in our SILS specimens.
Results:
The median predicted number of lymph nodes was 11 (4.5-14.8) compared with 18 (5-44) in the SILS specimens (P < 0.001). In all subgroups analysed for various operations, the lymph node harvest in the SILS specimens was significantly higher than predicted.
Conclusion:
In terms of lymph node harvest SILS seems to be comparable to conventional open or laparoscopic surgery.
