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Ishida et al. Mini-invasive Surg 2018;2:31 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.53

Review Open Access

Reduced-port surgery for rectal cancer

Takashi Ishida , Kohei Shigeta , Koji Okabayashi , Masashi Tsuruta , Hirotoshi Hasegawa ,
2
1
1
1
1
Yuko Kitagawa 1
1 Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
2 Department of Surgery, Tokyo Dental College Ichikawa General Hospital, Chiba 272-8513, Japan.
Correspondence to: Dr. Kohei Shigeta, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
E-mail: ohlkoh@gmail.com
How to cite this article: Ishida T, Shigeta K, Okabayashi K, Tsuruta M, Hasegawa H, Kitagawa Y. Reduced-port surgery for
rectal cancer. Mini-invasive Surg 2018;2:31. http://dx.doi.org/10.20517/2574-1225.2018.53

Received: 17 Jul 2018 First Decision: 20 Aug 2018 Revised: 4 Sep 2018 Accepted: 4 Sep 2018 Published: 28 Sep 2018

Science Editor: Gordon N. Buchanan Copy Editor: Cui Yu Production Editor: Zhong-Yu Guo

Abstract
Laparoscopic surgery for rectal cancer has short-term and long-term oncological outcomes similar to those of open
surgery. Conventional multiport laparoscopic surgery (CMLS) for rectal cancer requires four or five abdominal incisions
for trocars, each of which could lead to complications and/or pain. Single-incision laparoscopic surgery (SILS) would
reduce the incidence of such wound-related complications and achieve better cosmetic outcomes relative to CMLS. The
potential advantages of SILS are less pain and more rapid recovery than achieved with CMLS. However, SILS is rarely
used for rectal cancer because of the high-level technical expertise required. Reduced-port laparoscopic surgery (RPS),
which involves one additional port, may bridge the technical gap between CMLS and SILS and has a less steep learning
curve. RPS for rectal cancer has a short history, and its usefulness has not yet been fully established. Here, we review the
present situation, challenges, and future prospects for RPS for rectal cancer.

Keywords: Laparoscopic surgery, rectal cancer, reduced port surgery

INTRODUCTION
Large randomized trials [Conventional versus laparoscopic-assisted surgery in colorectal cancer (CLASICC),
Clinical Outcomes of Surgical Therapy (COST), Barcelona, JCOG0404] and a meta-analysis have
demonstrated that laparoscopic surgery for colon cancer is not only safe, but also associated with better
[1-5]
short-term outcomes, with no negative effect on long-term survival . They also revealed trends toward
reduced postoperative morbidity, intraoperative blood loss, and pain, as well as faster recovery and better
quality of life for laparoscopic surgery compared with open surgery [1,4,6-9] . The disadvantages were a longer

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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