Recent clinical research advances of reduced-port laparoscopic surgery for rectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Xi ^1,2 , CHEN Yijia ^1,3 , HUANG Wei ¹ ,  ZHANG Lin ^1,2,3

1. Department of Gastrointestinal Surgery, Chengdu Military General Hospital, Chengdu 610083, P. R. China;
2. School of Clinical Medicine, Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;
3. School of Clinical Medicine, Southwest Jiaotong University, Chengdu 610031, P. R. China;

Corresponding?author：

ZHANG Lin, Email: flysky8026@aliyun.com

Keywords：

rectal cancer; radical resection; minimal invasiveness; reduced-port laparoscopic surgery

DOI：

10.7507/1007-9424.201804070

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To understand status of technical realization, present development, faced problems, and application prospects of reduced-port laparoscopic surgery for rectal cancer, and to analyze safety and feasibility so as to provide theoretical and practical basis for clinical application and promotion. Method By searching the databases such as Medline, Embase, and Wanfang, etc., the relevant literatures about reduced-port laparoscopic surgery for rectal cancer were collected and reviewed. Results At present, the most common reduced-port laparoscopic surgery was the 1-port laparoscopic surgery, 2-port laparoscopic surgery, and 3-port laparoscopic surgery. The 1-port laparoscopic surgery had the effects of minimal invasiveness and cosmesis, but it was difficult to perform. The 2-port laparoscopic surgery for rectal cancer preserved as far as possible the effect of minimal invasiveness, the difficulty of procedure was reduced greatly, which was easy to be learnt and promoted. The experience of the 3-port laparoscopic surgery for rectal cancer contributed to the technical development of the 1-port laparoscopic surgery, with no need for the assisted incision for intraoperative specimen. The reduced-port laparoscopic surgery for rectal cancer was technically feasible and safe, which possessed the equal or better short-term outcomes as compared with the conventional 5-port laparoscopic or open surgery beside the radical resection for rectal cancer. However, the stringent technique for the laparoscopic surgery was necessary and it needed to overcome the learning curve. Conclusions Reduced-port laparoscopic surgery has some obvious advantages in minimal invasiveness, cosmesis, and enhanced recovery. More large-sample, multi-center, randomized controlled trials are eager to further confirm safety, effectiveness, and feasibility of reduced-port laparoscopic surgery for rectal cancer.

Citation： LIU Xi, CHEN Yijia, HUANG Wei, ZHANG Lin. Recent clinical research advances of reduced-port laparoscopic surgery for rectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(10): 1270-1275. doi: 10.7507/1007-9424.201804070 Copy

1.	Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparascopic colectomy). Surg Laparosc Endosc, 1991, 1(3): 144-150.
2.	Chen K, Cao G, Chen B, et al. Laparoscopic versus open surgery for rectal cancer: A meta-analysis of classic randomized controlled trials and high-quality nonrandomized studies in the last 5 years. Int J Surg, 2017, 39: 1-10.
3.	Curcillo PG 2nd, Podolsky ER, King SA. The road to reduced port surgery: From single big incisions to single small incisions, and beyond. World J Surg, 2011, 35(7): 1526-1531.
4.	Podolsky ER, St John-Dillon L, King SA, et al. Reduced port surgery: an economical, ecological, educational, and efficient approach to development of single port access surgery. Surg Technol Int, 2010, 20: 41-46.
5.	Tawfik Amina A, Elsaba TM, Amira G. Three ports laparoscopic resection for colorectal cancer: a step on refining of reduced port surgery. ISRN Surg, 2014, 2014: 781549.
6.	Hirano Y, Hattori M, Douden K, et al. Single-incision plus one port laparoscopic anterior resection for rectal cancer as a reduced port surgery. Scand J Surg, 2012, 101(4): 283-286.
7.	Fujino S, Miyoshi N, Ohue M, et al. Z skin incision in reduced-port surgery for colorectal cancer. Mol Clin Oncol, 2016, 4(4): 611-615.
8.	Dumont F, Thibaudeau E, Benhaim L, et al. Single-port endoscopic mesocolic and mesorectal excision using an extraperitoneal approach. Surg Endosc, 2017, 31(1): 469-475.
9.	申占龍, 葉穎江, 姜可偉, 等. 經會陰單孔腹腔鏡輔助的肛提肌外腹會陰聯合切除術在低位直腸癌治療中的應用. 中華胃腸外科雜志, 2016, 19(3): 274-277.
10.	Kawahara H, Watanabe K, Ushigome T, et al. Umbilical incision laparoscopic surgery with one assist port for anterior resection. Dig Surg, 2010, 27(5): 364-366.
11.	張慶彤, 劉亞莉, 張旭, 等. 減孔與多孔腹腔鏡手術治療直腸癌臨床療效對比研究. 中國實用外科雜志, 2017, 37(3): 276-280.
12.	Bae SU, Baek SJ, Min BS, et al. Reduced-port laparoscopic surgery for a tumor-specific mesorectal excision in patients with colorectal cancer: initial experience with 20 consecutive cases. Ann Coloproctol, 2015, 31(1): 16-22.
13.	Keller DS, Flores-Gonzalea JR, Sandhu J, et al. SILS v SILS+1: a case-matched comparison for colorectal surgery. J Gastrointest Surg, 2015, 19(10): 1875-1879.
14.	Ishikawa T, Homma S, Shibasaki S, et al. Dual-port laparoscopic abdominoperineal resection using the intended stoma site as the multichannel port. Surg Today, 2015, 45(12): 1583-1587.
15.	Liu XP, Wu PH, Feng QF, et al. Comparison of improved three-port laparoscopic surgery and traditional five-port laparoscopic surgery for rectal cancer. Int J Clin Exp Med, 2016, 9(10): 19821-19825.
16.	Madhoun N, Keller DS, Haas EM. Review of single incision laparoscopic surgery in colorectal surgery. World J Gastroenterol, 2015, 21(38): 10824-10829.
17.	李國新, 李俊蒙, 王亞楠, 等. 單孔和減孔腹腔鏡結直腸癌切除術發展現狀及展望. 中華外科雜志, 2017, 55(7): 486-490.
18.	Zhou YM, Wu LP, Zhao YF, et al. Single-incision versus conventional laparoscopy for colorectal disease: a meta-analysis. Dig Dis Sci, 2012, 57(8): 2103-2112.
19.	Li HJ, Huang L, Li TJ, et al. Short-term outcomes of single-incision versus conventional laparoscopic surgery for colorectal diseases: meta-analysis of randomized and prospective evidence. J Gastrointest Surg, 2017, 21(11): 1931-1945.
20.	Lv C, Wu S, Wu Y, et al. Single-incision laparoscopic versus traditional multiport laparoscopic colorectal surgery—a cumulative meta-analysis and systematic review. Int J Colorectal Dis, 2013, 28(5): 611-621.
21.	Lolle I, Rosenstock S, Bulut O. Single-port laparoscopic rectal surgery—a systematic review. Dan Med J, 2014, 61(7): A4878.
22.	Lainas P, Tranchart H, TzanisS D, et al. High rectal tumor resection using single-incision laparoscopic approach. J Visc Surg, 2016, 153(2): 147-148.
23.	Gash K, Bicsak M, Dixon A. Medium term oncological outcomes of single incision laparoscopic surgery for rectal cancer. Gut, 2015, 64(Suppl 1): A533-A534.
24.	Gash K, Bicsak M, Dixon A. Single-incision laparoscopic surgery for rectal cancer: early results and medium-term oncological outcome. Colorectal Dis, 2015, 17(12): 1071-1078.
25.	Bulut O, Aslak KK, Rosenstock S. Technique and short-term outcomes of single-port surgery for rectal cancer: a feasibility study of 25 patients. Scand J Surg, 2014, 103(1): 26-33.
26.	Weiss H, Zorron R, Vestweber KH, et al. ECSPECT prospective multicentre registry for single-port laparoscopic colorectal procedures. Br J Surg, 2017, 104(1): 128-137.
27.	Weiss H, Gash K, Dixon A, et al. Short-term results of 2 032 single port colorectal procedures with preoperative risk profiling: ECSPECT prospective multicentre registry. Gut, 2015, 64(Suppl 1): A2.
28.	Sourrouille I, Dumont F, Goere D, et al. Resection of rectal cancer via an abdominal single-port access: short-term results and comparison with standard laparoscopy. Dis Colon Rectum, 2013, 56(11): 1203-1210.
29.	Bulut O, Aslak KK, Levic K, et al. A randomized pilot study on single-port versus conventional laparoscopic rectal surgery: effects on postoperative pain and the stress response to surgery. Tech Coloproctol, 2015, 19(1): 11-22.
30.	Nerup N, Rosenstock S, Bulut TO. Comparison of single-port and conventional laparoscopic abdominoperineal resection. J Minim Access Surg, 2018, 14(1): 27-32.
31.	Rink AD, Vestweber B, Paul C, et al. Single-incision laparoscopic surgery for colorectal malignancy—results of a matched-pair comparison to conventional surgery. Int J Colorectal Dis, 2015, 30(1): 79-85.
32.	Chen WH, Kang L, Luo SL, et al. Transanal total mesorectal excision assisted by single-port laparoscopic surgery for low rectal cancer. Tech Coloproctol, 2015, 19(9): 527-534.
33.	Foo DC, Choi HK, Wei R, et al. Transanal total mesorectal excision with single-incision laparoscopy for rectal cancer. JSLS, 2016, 20(2): 1-7.
34.	Choi BJ, Lee SC, Kang WK. Single-port laparoscopic total mesorectal excision with transanal resection (transabdominal transanal resection) for low rectal cancer: Initial experience with 22 cases. Int J Surg, 2013, 11(9): 858-863.
35.	Buchs NC, Kraus R, Mortensen NJ, Transanal total mesorectal excision with single-incision laparoscopy for rectal cancer. Endoscopically assisted extralevator abdominoperineal excision. Colorectal Dis, 2015, 17(12): O277-O280.
36.	韓加剛, 王振軍, 高志剛, 等. 經腹和會陰雙腹腔鏡下肛提肌外腹會陰聯合切除術在低位直腸癌中的應用. 中華胃腸外科雜志, 2016, 19(6): 654-658.
37.	Hirano Y, Hattori M, Douden K, et al. Short-term clinical and oncological outcomes after single-incision plus one port laparoscopic anterior resection for rectal cancer. Dig Surg, 2018, 35(2): 111-115.
38.	張宏, 凌云志, 叢進春, 等. 改良兩孔法與常規五孔法腹腔鏡直腸癌前切除術短期療效比較. 中國實用外科雜志, 2016, 36(10): 1084-1089.
39.	Kawahara H, Misawa T, Watanabe K, et al. Feasibility of single-incision laparoscopic surgery plus one assist port for anterior resection. Anticancer Res, 2016, 36(1): 467-469.
40.	Liu R, Wang Y, Zhang Z, et al. Assessment of treatment options for rectosigmoid cancer: single-incision plus one port laparoscopic surgery, single-incision laparoscopic surgery, and conventional laparoscopic surgery. Surg Endosc, 2017, 31(6): 2437-2450.
41.	Kawamata F, Homma S, Minagawa N, et al. Comparison of single-incision plus one additional port laparoscopy-assisted anterior resection with conventional laparoscopy-assisted anterior resection for rectal cancer. World J Surg, 2014, 38(10): 2716-2723.
42.	Tokuoka M, Ide Y, Yamato H, et al. Single-incision plus one port laparoscopic total pelvic exenteration after neoadjuvant chemotherapy for advanced primary rectal cancer: a case report. World J Surg, 2015, 100(9-10): 1265-1270.
43.	Tokuoka M, Ide Y, Takeda M, et al. Single-incision plus one-port laparoscopic abdominoperineal resection with bilateral pelvic lymph node dissection for advanced rectal cancer: a case report. Int Surg, 2015, 100(1): 15-20.
44.	Tokuoka M, Ide Y, Takeda M, et al. Single-incision plus one port laparoscopic total mesorectal excision and bilateral pelvic node dissection for advanced rectal cancer—a medial umbilical ligament approach. Int Surg, 2015, 100(3): 417-422.
45.	李國新, 李俊蒙, 王亞楠, 等. 兩孔法腹腔鏡乙狀結腸及直腸上段癌根治性切除術的回顧性對比研究. 中華外科雜志, 2017, 55(7): 515-520.
46.	Zhang H, Ling Y, Cong J, et al. Two-port laparoscopic anterior resection through a self-made glove device versus conventional laparoscopic anterior resection for rectal cancer: a comparison of short-term surgical results. World J Surg Oncol, 2016, 14(1): 275.
47.	Lim SW, Kim HJ, Kim CH, et al. Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer. Tech Coloproctol, 2013, 17(2): 193-199.
48.	宋海良, 李亞軍, 王曉琴, 等. 減孔較五孔腹腔鏡對結直腸癌根治性切除術中出血量、淋巴結清掃數目及恢復情況分析. 中華普外科手術學雜志(電子版), 2017, 11(5): 403-405.
49.	Hamabe A, Takemasa I, Hata T, et al. Patient body image and satisfaction with surgical wound appearance after reduced port surgery for colorectal diseases. World J Surg, 2016, 40(7): 1748-1754.
50.	Jung KU, Yun SH, Cho YB, et al. Single incision and reduced port laparoscopic low anterior resection for rectal cancer: initial experience in 96 cases. ANZ J Surg, 2016, 86(5): 403-407.
51.	葉楓, 季曉頻, 張弢, 等. 三孔法腹腔鏡直腸癌根治術的臨床研究. 腹部外科, 2014, 27(4): 271-275.
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1. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparascopic colectomy). Surg Laparosc Endosc, 1991, 1(3): 144-150.
2. Chen K, Cao G, Chen B, et al. Laparoscopic versus open surgery for rectal cancer: A meta-analysis of classic randomized controlled trials and high-quality nonrandomized studies in the last 5 years. Int J Surg, 2017, 39: 1-10.
3. Curcillo PG 2nd, Podolsky ER, King SA. The road to reduced port surgery: From single big incisions to single small incisions, and beyond. World J Surg, 2011, 35(7): 1526-1531.
4. Podolsky ER, St John-Dillon L, King SA, et al. Reduced port surgery: an economical, ecological, educational, and efficient approach to development of single port access surgery. Surg Technol Int, 2010, 20: 41-46.
5. Tawfik Amina A, Elsaba TM, Amira G. Three ports laparoscopic resection for colorectal cancer: a step on refining of reduced port surgery. ISRN Surg, 2014, 2014: 781549.
6. Hirano Y, Hattori M, Douden K, et al. Single-incision plus one port laparoscopic anterior resection for rectal cancer as a reduced port surgery. Scand J Surg, 2012, 101(4): 283-286.
7. Fujino S, Miyoshi N, Ohue M, et al. Z skin incision in reduced-port surgery for colorectal cancer. Mol Clin Oncol, 2016, 4(4): 611-615.
8. Dumont F, Thibaudeau E, Benhaim L, et al. Single-port endoscopic mesocolic and mesorectal excision using an extraperitoneal approach. Surg Endosc, 2017, 31(1): 469-475.
9. 申占龍, 葉穎江, 姜可偉, 等. 經會陰單孔腹腔鏡輔助的肛提肌外腹會陰聯合切除術在低位直腸癌治療中的應用. 中華胃腸外科雜志, 2016, 19(3): 274-277.
10. Kawahara H, Watanabe K, Ushigome T, et al. Umbilical incision laparoscopic surgery with one assist port for anterior resection. Dig Surg, 2010, 27(5): 364-366.
11. 張慶彤, 劉亞莉, 張旭, 等. 減孔與多孔腹腔鏡手術治療直腸癌臨床療效對比研究. 中國實用外科雜志, 2017, 37(3): 276-280.
12. Bae SU, Baek SJ, Min BS, et al. Reduced-port laparoscopic surgery for a tumor-specific mesorectal excision in patients with colorectal cancer: initial experience with 20 consecutive cases. Ann Coloproctol, 2015, 31(1): 16-22.
13. Keller DS, Flores-Gonzalea JR, Sandhu J, et al. SILS v SILS+1: a case-matched comparison for colorectal surgery. J Gastrointest Surg, 2015, 19(10): 1875-1879.
14. Ishikawa T, Homma S, Shibasaki S, et al. Dual-port laparoscopic abdominoperineal resection using the intended stoma site as the multichannel port. Surg Today, 2015, 45(12): 1583-1587.
15. Liu XP, Wu PH, Feng QF, et al. Comparison of improved three-port laparoscopic surgery and traditional five-port laparoscopic surgery for rectal cancer. Int J Clin Exp Med, 2016, 9(10): 19821-19825.
16. Madhoun N, Keller DS, Haas EM. Review of single incision laparoscopic surgery in colorectal surgery. World J Gastroenterol, 2015, 21(38): 10824-10829.
17. 李國新, 李俊蒙, 王亞楠, 等. 單孔和減孔腹腔鏡結直腸癌切除術發展現狀及展望. 中華外科雜志, 2017, 55(7): 486-490.
18. Zhou YM, Wu LP, Zhao YF, et al. Single-incision versus conventional laparoscopy for colorectal disease: a meta-analysis. Dig Dis Sci, 2012, 57(8): 2103-2112.
19. Li HJ, Huang L, Li TJ, et al. Short-term outcomes of single-incision versus conventional laparoscopic surgery for colorectal diseases: meta-analysis of randomized and prospective evidence. J Gastrointest Surg, 2017, 21(11): 1931-1945.
20. Lv C, Wu S, Wu Y, et al. Single-incision laparoscopic versus traditional multiport laparoscopic colorectal surgery—a cumulative meta-analysis and systematic review. Int J Colorectal Dis, 2013, 28(5): 611-621.
21. Lolle I, Rosenstock S, Bulut O. Single-port laparoscopic rectal surgery—a systematic review. Dan Med J, 2014, 61(7): A4878.
22. Lainas P, Tranchart H, TzanisS D, et al. High rectal tumor resection using single-incision laparoscopic approach. J Visc Surg, 2016, 153(2): 147-148.
23. Gash K, Bicsak M, Dixon A. Medium term oncological outcomes of single incision laparoscopic surgery for rectal cancer. Gut, 2015, 64(Suppl 1): A533-A534.
24. Gash K, Bicsak M, Dixon A. Single-incision laparoscopic surgery for rectal cancer: early results and medium-term oncological outcome. Colorectal Dis, 2015, 17(12): 1071-1078.
25. Bulut O, Aslak KK, Rosenstock S. Technique and short-term outcomes of single-port surgery for rectal cancer: a feasibility study of 25 patients. Scand J Surg, 2014, 103(1): 26-33.
26. Weiss H, Zorron R, Vestweber KH, et al. ECSPECT prospective multicentre registry for single-port laparoscopic colorectal procedures. Br J Surg, 2017, 104(1): 128-137.
27. Weiss H, Gash K, Dixon A, et al. Short-term results of 2 032 single port colorectal procedures with preoperative risk profiling: ECSPECT prospective multicentre registry. Gut, 2015, 64(Suppl 1): A2.
28. Sourrouille I, Dumont F, Goere D, et al. Resection of rectal cancer via an abdominal single-port access: short-term results and comparison with standard laparoscopy. Dis Colon Rectum, 2013, 56(11): 1203-1210.
29. Bulut O, Aslak KK, Levic K, et al. A randomized pilot study on single-port versus conventional laparoscopic rectal surgery: effects on postoperative pain and the stress response to surgery. Tech Coloproctol, 2015, 19(1): 11-22.
30. Nerup N, Rosenstock S, Bulut TO. Comparison of single-port and conventional laparoscopic abdominoperineal resection. J Minim Access Surg, 2018, 14(1): 27-32.
31. Rink AD, Vestweber B, Paul C, et al. Single-incision laparoscopic surgery for colorectal malignancy—results of a matched-pair comparison to conventional surgery. Int J Colorectal Dis, 2015, 30(1): 79-85.
32. Chen WH, Kang L, Luo SL, et al. Transanal total mesorectal excision assisted by single-port laparoscopic surgery for low rectal cancer. Tech Coloproctol, 2015, 19(9): 527-534.
33. Foo DC, Choi HK, Wei R, et al. Transanal total mesorectal excision with single-incision laparoscopy for rectal cancer. JSLS, 2016, 20(2): 1-7.
34. Choi BJ, Lee SC, Kang WK. Single-port laparoscopic total mesorectal excision with transanal resection (transabdominal transanal resection) for low rectal cancer: Initial experience with 22 cases. Int J Surg, 2013, 11(9): 858-863.
35. Buchs NC, Kraus R, Mortensen NJ, Transanal total mesorectal excision with single-incision laparoscopy for rectal cancer. Endoscopically assisted extralevator abdominoperineal excision. Colorectal Dis, 2015, 17(12): O277-O280.
36. 韓加剛, 王振軍, 高志剛, 等. 經腹和會陰雙腹腔鏡下肛提肌外腹會陰聯合切除術在低位直腸癌中的應用. 中華胃腸外科雜志, 2016, 19(6): 654-658.
37. Hirano Y, Hattori M, Douden K, et al. Short-term clinical and oncological outcomes after single-incision plus one port laparoscopic anterior resection for rectal cancer. Dig Surg, 2018, 35(2): 111-115.
38. 張宏, 凌云志, 叢進春, 等. 改良兩孔法與常規五孔法腹腔鏡直腸癌前切除術短期療效比較. 中國實用外科雜志, 2016, 36(10): 1084-1089.
39. Kawahara H, Misawa T, Watanabe K, et al. Feasibility of single-incision laparoscopic surgery plus one assist port for anterior resection. Anticancer Res, 2016, 36(1): 467-469.
40. Liu R, Wang Y, Zhang Z, et al. Assessment of treatment options for rectosigmoid cancer: single-incision plus one port laparoscopic surgery, single-incision laparoscopic surgery, and conventional laparoscopic surgery. Surg Endosc, 2017, 31(6): 2437-2450.
41. Kawamata F, Homma S, Minagawa N, et al. Comparison of single-incision plus one additional port laparoscopy-assisted anterior resection with conventional laparoscopy-assisted anterior resection for rectal cancer. World J Surg, 2014, 38(10): 2716-2723.
42. Tokuoka M, Ide Y, Yamato H, et al. Single-incision plus one port laparoscopic total pelvic exenteration after neoadjuvant chemotherapy for advanced primary rectal cancer: a case report. World J Surg, 2015, 100(9-10): 1265-1270.
43. Tokuoka M, Ide Y, Takeda M, et al. Single-incision plus one-port laparoscopic abdominoperineal resection with bilateral pelvic lymph node dissection for advanced rectal cancer: a case report. Int Surg, 2015, 100(1): 15-20.
44. Tokuoka M, Ide Y, Takeda M, et al. Single-incision plus one port laparoscopic total mesorectal excision and bilateral pelvic node dissection for advanced rectal cancer—a medial umbilical ligament approach. Int Surg, 2015, 100(3): 417-422.
45. 李國新, 李俊蒙, 王亞楠, 等. 兩孔法腹腔鏡乙狀結腸及直腸上段癌根治性切除術的回顧性對比研究. 中華外科雜志, 2017, 55(7): 515-520.
46. Zhang H, Ling Y, Cong J, et al. Two-port laparoscopic anterior resection through a self-made glove device versus conventional laparoscopic anterior resection for rectal cancer: a comparison of short-term surgical results. World J Surg Oncol, 2016, 14(1): 275.
47. Lim SW, Kim HJ, Kim CH, et al. Umbilical incision laparoscopic colectomy with one additional port for colorectal cancer. Tech Coloproctol, 2013, 17(2): 193-199.
48. 宋海良, 李亞軍, 王曉琴, 等. 減孔較五孔腹腔鏡對結直腸癌根治性切除術中出血量、淋巴結清掃數目及恢復情況分析. 中華普外科手術學雜志(電子版), 2017, 11(5): 403-405.
49. Hamabe A, Takemasa I, Hata T, et al. Patient body image and satisfaction with surgical wound appearance after reduced port surgery for colorectal diseases. World J Surg, 2016, 40(7): 1748-1754.
50. Jung KU, Yun SH, Cho YB, et al. Single incision and reduced port laparoscopic low anterior resection for rectal cancer: initial experience in 96 cases. ANZ J Surg, 2016, 86(5): 403-407.
51. 葉楓, 季曉頻, 張弢, 等. 三孔法腹腔鏡直腸癌根治術的臨床研究. 腹部外科, 2014, 27(4): 271-275.
52. 劉曉平, 鄧偉, 曾祥福. 改良三孔法與五孔法腹腔鏡直腸癌手術的對比研究. 腹腔鏡外科雜志, 2013, 18(9): 672-675.
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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Recent clinical research advances of reduced-port laparoscopic surgery for rectal cancer

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