Comparison between transverse mini-incision and longitudinal mini-incision for the resection of locally advanced colonic cancer

Abstract

We performed a retrospective review of non-overweight (body mass index ≤ 25 kg/m(2)) patients scheduled to undergo a curative resection of locally advanced colon cancer via a transverse mini-incision (n = 62) or a longitudinal mini-incision (skin incision ≤7 cm, n = 62), with the latter group of patients randomly selected as historical controls matched with the former group according to tumor location. Extension of the transverse mini-incision wound was necessary in 3 patients (5%). Both groups were largely equivalent in terms of demographic, clinicopathological, and surgical factors and frequency of postoperative complications. Postoperative analgesic was significantly less (P = 0.04) and postoperative length of the hospital stay was significantly shorter (P < 0.01) in the transverse mini-incision group. Concerning a mini-incision approach for locally advanced colonic cancer, a transverse incision seems to be advantageous with regard to minimal invasiveness and early recovery compared with a longitudinal incision.

Keywords: Colectomy; Colonic cancer; Mini-laparotomy; Transverse incision.

Fig. 1

(A) Schema showing transverse mini-incision according to the tumor site: (a) right-sided colon, (b) mid-transverse colon, and (c) left-sided colon. (B) Right-sided colon retracted through the wound. (C) Photograph showing a wound retractor attached to the edge of the transverse mini-incision in a patient with ascending colon cancer. (D) Exposed superior mesenteric vein and superior mesenteric artery during standard lymph node dissection for the ascending colon. The ileocolic artery being ligated just prior to dissection.