Single Port and Conventional Laparoscopy in Colorectal Surgery: Comparison of Two Techniques

J Laparoendosc Adv Surg Tech A. 2018 Jan;28(1):65-70. doi: 10.1089/lap.2017.0331. Epub 2017 Oct 4.

Abstract

Background: Single-incision laparoscopic surgery (SILS) was introduced to further the enhanced outcome of conventional multiport laparoscopy (CML). We compared their short- and long-term outcomes in colorectal surgery.

Materials and methods: Retrospective review of patients who underwent elective laparoscopic colorectal surgery during 3-year period. Patients' data, surgery outcomes, and oncological results were compared.

Results: Sixty-one patients (33 male, 28 female), mean age 67.4 years, underwent laparoscopic colonic resections: 28 SILS and 33 CML. Twenty-three (37.7%) patients had previous abdominal surgery. There were 19 (31.2%) right, 9 (14.7%) left, and 2 (3.3%) total colectomies, 16 (26.2%) sigmoidectomies, 13 (21.3%) anterior and 2 (3.3%) abdominoperineal resections. Colonic malignancy was a main indication for the surgery in 51 (83.6%) patients. Mean surgery time and postoperative stay were 92.0 minutes and 9 days, respectively. Pathological examination revealed stage I colon cancer in 16 (32%), stage II in 22 (44%), stage III in 10 (20%), and stage IV in 2 (4%) patients. Mean number of retrieved lymph nodes was 19 ± 13.5. No differences were found between groups in demographic data, type of surgery, surgery time and hospital stay, pathological results and tumor staging, and disease-free and overall survivals. In the SILS group, placement of additional trocar was required in 7 (25%) and conversion in 3 (10.7%) cases compared with 1 (3%) case of conversion to formal laparotomy in the CML group. Overall postoperative morbidity was 16.4%. There was no mortality in both the groups. During the study period, 3 patients from the CML group had cancer recurrence.

Conclusions: SILS is a feasible and safe technique compared with CML in terms of surgical and oncological outcomes.

Keywords: colon cancer; colon resection; colorectal surgery; laparoscopy; single port.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colectomy / methods
  • Colon, Sigmoid / surgery
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Conversion to Open Surgery
  • Disease-Free Survival
  • Female
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local* / surgery
  • Neoplasm Staging
  • Operative Time
  • Postoperative Complications / etiology
  • Rectal Neoplasms / pathology
  • Rectal Neoplasms / surgery*
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Young Adult