Minilaparotomy Approach Employing a K?stner Incision for Rectal Cancer Resection: Report of Three Cases

A minilaparotomy approach (? 7 cm) for colorectal cancer resection is feasible and safe. Such minilaparotomy generally employs a small vertical incision. A low transverse abdominal incision (a K?stner incision) has been shown to be associated with cosmetic advantage, less postoperative pain, and fewer wound-complications than the midline incision. We report three cases (75-year-old female, 64-year-old male, and 74-year-old female) who underwent anterior resection of rectal cancer via a minilaparotomy approach employing the K?stner incision. No hand-port or laparoscope was used. The median body mass index was 18.9 (range, 18.3-19.3) kg/m2. The rectal tumors were located in the rectosigmoid and the upper rectum. There were no intraoperative complications. The median operating time and operative blood loss were 160 (range, 159-162) min and 80 (range, 30-90) ml, respectively. All tumors were curatively resected. The patients quickly returned to normal function without morbidity or mortality. No patients developed wound-related complications. During a median follow-up period of 27.4 (range, 26.8-29.0) months, all patients are alive without tumor recurrence. In addition, neither incisional hernia nor nerve damage developed. We conclude that the minilaparotomy approach employing a K?stner incision is a less invasive and an attractive method with a cosmetic advantage for rectal cancer resection in selected patients