Comparison of the short-term outcomes of reduced-port laparoscopic surgery and conventional multiport surgery in colon cancer: a propensity score matching analysis

Abstract

PurposeThe feasibility of reduced-port laparoscopic surgery (RPS) in colon cancer remains uncertain. This study aimed to compare the short-term outcomes of RPS and multiport surgery (MPS) in colon cancer using propensity score matching analysis.MethodsA total of 302 patients with colon cancer who underwent laparoscopic anterior resection (AR) (n = 184) or right hemicolectomy (RHC) (n = 118) by a single surgeon between January 2011 and January 2017 were included. Short-term outcomes were compared between RPS and MPS.ResultsSeventy-three patients in the AR group and 23 in the RHC group underwent RPS. After propensity score matching, the RPS and MPS groups showed similar baseline characteristics. In the AR group, patients who underwent RPS (n = 72) showed a shorter operation time (114.4 ± 28.7 minutes vs. 126.7 ± 34.5 minutes, P = 0.021) and a longer time to gas passage (3.6 ± 1.7 days vs. 2.6 ± 1.5 days, P = 0.005) than MPS (n = 72). Similarly, in the RHC group, the operation time was shorter (112.6 ± 26.0 minutes vs. 146.5 ± 31.2 minutes, P = 0.005), and the time to first flatus was longer (2.7 ±1.1 days vs. 3.8 ± 1.3 days, P = 0.004) in the RPS group (n = 23) than in the MPS group (n = 23). Other short-term outcomes were similar for RPS and MPS in both the AR and RHC groups.ConclusionThe short-term outcomes of RPS were found to be acceptable compared to those of MPS in colon cancer surgery.

Reduced-port surgery for rectal cancer

“…Therefore, patients who undergo RPS have better postoperative outcomes. However, the estimated blood loss, morbidity rate, conversion rate, and number of harvested lymph nodes were comparable, suggesting that RPS is a feasible and safe procedure in the early postoperative stage [27,30] . Furthermore, the postoperative neutrophil count, C-reactive protein level, interleukin-6 level, and body temperature were significantly lower after RPS compared with CMLS [27,32] , which may accelerate recovery.…”

“…RPS has become more feasible due to the accumulation of experience and improvement of laparoscopic tools, such as energy devices and specific forceps. Although they included relatively few patients with rectal cancer, four retrospective studies have compared RPS with CMLS for the treatment of this disease [27,[30][31][32] . The advantages of RPS over CMLS are summarized in Table 1.…”

“…Regarding short-term outcomes, the operation time is shorter for RPS than for CMLS [27,30,31] , possibly due to selection bias [30,31] or a decreased time to wound closure as a result of the fewer and smaller wounds created during RPS [30] .…”

Serum 1,3-Beta-D-Glucan Values During and After Laparoscopic and Open Intestinal Surgery

“…In this prospective study, all patients undergoing laparoscopic or open intestinal surgery involving the small bowel and/or colon and/or rectum at the Hospital of St. John of God (Barmherzige Brüder), Graz, Austria, between April and June 2018 were asked to participate in the study and included after they provided informed consent. Open and laparoscopic surgical procedures were performed as applied in clinical routine and published previously [20, 21]. Assignment to 1 of the groups was performed by the surgeons according to the underlying disease and technical aspects.…”

Short‐ And medium‐term outcomes of reduced‐port laparoscopic surgery in elderly patients with upper rectal cancer: A retrospective cohort study

“…For radical treatment of colorectal cancer, as a reduced‐port laparoscopic surgery (RPLS), SPLS would present additional specific challenges 8‐23 . First, the duration of surgery is significantly longer than for traditional laparoscopic surgery.…”