Right lower transverse incision versus vertical transumbilical incision for laparoscopic specimen extraction in patients with left-sided colorectal cancer: a comparative study of two mini-laparotomy techniques

BACKGROUND The aim of this study was to compare the short-term outcomes of a right lower transverse incision with a vertical transumbilical incision for laparoscopic specimen extraction in patients with left-sided colorectal cancer. METHODS One hundred eighty-three patients who underwent laparoscopic resection for rectosigmoid colon or upper rectal cancer were included. Propensity score matching was performed to reduce bias caused by differences between the right lower transverse incision (RLT group) and vertical transumbilical incision (VTU group). RESULTS After matching, 57 patients in the RLT group and 57 patients in the VTU group were found to be equivalent regarding baseline clinicopathological characteristics. Median follow-up time was 31 months. The RLT group showed comparable results to those of the VTU group in terms of perioperative outcomes, postoperative course, and postoperative complications. However, the proportion of patients requiring an additional incision for diverting stoma was significantly lower in the RLT group (p = 0.003). CONCLUSIONS A right lower transverse incision appears to be as effective as a vertical transumbilical incision regarding short-term outcomes after laparoscopic surgery for left-sided colorectal cancer and may be a preferred extraction site because of its lowered risk of additional mini-laparotomy for diverting stoma.