Short-term and long-term outcomes of single-incision versus multi-incision laparoscopic resection for colorectal cancer: a propensity-score-matched analysis of 214 cases

Katsuno, Goutaro; Fukunaga, Masaki; Nagakari, Kunihiko; Yoshikawa, Seichiro; Azuma, Daisuke; Kohama, Shintaro

doi:10.1007/s00464-015-4371-y

Cited by 63 publications

(54 citation statements)

References 38 publications

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“…Single incision gastrectomy for gastric cancer or matched retrospective study, even though the number of sample size was limited (11)(12)(13)(14).…”

Section: Review Articlementioning

confidence: 99%

Single incision gastrectomy for gastric cancer

Suh

Lee

Yang

2016

Transl. Gastroenterol. Hepatol.

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Based on rapid development of laparoscopic techniques and instruments, single-incision laparoscopic surgery (SILS) is expected to be the next step of "more" minimally invasive surgery. A few institutions gradually started to report their experience of single incision gastrectomy (SIG) for gastric cancer, but it is still difficult to accept that SIG can be performed as a popular procedure because of its technical difficulty. For wide adoption of SIG, the simplicity, safety and reproducibility of not only lymph node dissection but also reconstruction should be evaluated compared to a conventional procedure. With a thorough understanding of unique characteristics of SILS, single incision distal gastrectomy (SIDG) for early gastric cancer performed by laparoscopic surgeons with advanced technique is expected to have promising potential about excellent cosmesis, comparable morbidity and mortality in carefully selected patients. For appropriate adoption and steady progress of this state-of-the art surgery, scientific evaluation with healthy critics is necessary with new generation of SILS instrument platform.

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“…Single incision gastrectomy for gastric cancer or matched retrospective study, even though the number of sample size was limited (11)(12)(13)(14).…”

Section: Review Articlementioning

confidence: 99%

Single incision gastrectomy for gastric cancer

Suh

Lee

Yang

2016

Transl. Gastroenterol. Hepatol.

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“…From 1,118 LAP cases, 107 cases each treated with single incision and conventional multiincision laparoscopic surgery were extracted and compared using propensity score-matched analysis. Wound pain was significantly milder in single incision cases, and there was no difference in the incidence of wound infection, anastomotic leakage, ileus, or long-term outcome between the groups, showing that it is a useful surgical procedure when it is performed by skilled surgeons for selected patients 15) ( Table-4A, B). Furthermore, I designed 2 surgical procedures reducing the size of incision in the umbilical region by extracting the specimen through the anus, in which completely intra-abdominal anastomosis was devised and the prolapsing technique described below was applied.…”

Section: Aiming At Reducing Invasiveness Of Laparoscopic Surgerymentioning

confidence: 99%

Encounter with Laparoscopic Surgery and Starting from Zero

Fukunaga

2017

Juntendo Medical Journal

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In 1990, the first laparoscopic cholectomy in Japan was performed, having a marked impact on extended laparotomy and extended operation which had been used for a long time. I initiated laparoscopic colectomy in 1993.At the beginning, no surgical text on laparoscopic surgery (LAP) was available and there was no instructor showing me a model, so that everything started from zero. I actively introduced LAP mainly for colorectal and gastric cancers and promoted its development.A quarter of a century has passed since the initiation of LAP for colorectal cancer. Laparoscopic colectomy has gained popularity recent years. At present, 60-70% of surgical colorectal cancer patients in Japan receive laparoscopic surgery, which is markedly different from the situation at the beginning. Actually, laparoscopic surgery has become the main surgery for colorectal cancer. It is essential for young surgeons responsible for the next generation to acquire the skills of laparoscopic surgery. It was my fortunate that I could be involved to a significant extent in the history of the marked changes in colorectal surgery.

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“…In the general colorectal population, single‐incision laparoscopic surgery (SILS) has been reported to further improve such outcomes . In particular, a decrease in the use of postoperative analgesics has been reported, probably as a result of the overall smaller incision size . However, requirements for postoperative analgesia have not yet been investigated for total colectomy (TC) in UC.…”

Section: Introductionmentioning

confidence: 99%

Impact of single‐incision laparoscopic surgery on postoperative analgesia requirements after total colectomy for ulcerative colitis: a propensity‐matched comparison with multiport laparoscopy

et al. 2019

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Aim To compare the requirements for postoperative analgesia in patients with ulcerative colitis after single‐incision versus multiport laparoscopic total colectomy. Method All patients undergoing single‐incision or multiport laparoscopic total colectomy as a first stage in the surgical treatment of ulcerative colitis between 2010 and 2016 at the University Hospital of Leuven were included. The cumulative dose of postoperative patient‐controlled analgesia was used as the primary end‐point. A Z‐transformation was performed combining values for patient‐controlled epidural analgesia and patient‐controlled intravenous analgesia, resulting in one hybrid outcome variable. The two groups were matched using propensity scores. Subgroup analysis was performed to analyse the impact of extraction site on postoperative pain. Results A total of 81 patients underwent total colectomy for ulcerative colitis (median age 35 years). Thirty patients underwent single‐incision laparoscopy, while 51 patients had a multiport approach. The mean normalized patient‐controlled analgesia dose was significantly lower in patients undergoing single‐incision laparoscopy (−0.33 vs 0.46, P < 0.001). This difference was no longer significant in subgroup analysis for patients with stoma site specimen extraction (P = 0.131). The odds of receiving tramadol postoperatively was 3.66 times lower after single‐incision laparoscopy (P = 0.008). The overall morbidity rate was 32.1% (26/81). The mean Comprehensive Complication Index in single‐incision and multiport laparoscopy group was 18.33 and 21.39, respectively (P = 0.506). Hospital stay was significantly shorter after single‐incision laparoscopic surgery (6.3 days vs 7.6 days, P = 0.032). Conclusion Single‐incision total colectomy was associated with lower postoperative analgesia requirements and shorter hospital stay, with comparable morbidity. However, the specimen extraction site played a significant role in postoperative pain control.

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Short-term and long-term outcomes of single-incision versus multi-incision laparoscopic resection for colorectal cancer: a propensity-score-matched analysis of 214 cases

Abstract: This study suggests that SILC for colorectal cancer is a safe and feasible option with better cosmetic results and less pain in strictly selected patients. SILC can also produce good oncological results with similar postoperative outcomes to MILC.

Cited by 63 publications

References 38 publications

Single incision gastrectomy for gastric cancer

Single incision gastrectomy for gastric cancer

Encounter with Laparoscopic Surgery and Starting from Zero

Impact of single‐incision laparoscopic surgery on postoperative analgesia requirements after total colectomy for ulcerative colitis: a propensity‐matched comparison with multiport laparoscopy

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