Single incision laparoscopic colectomy for colorectal cancer: comparison with conventional laparoscopic colectomy

Abstract

PurposeThe aim of this retrospective study was to evaluate the feasibility of single incision laparoscopic surgery (SILS), and to compare the short-term surgical outcomes with those of conventional laparoscopic surgery for colorectal cancer.MethodsForty-four patients who underwent SILS were compared with 263 patients who underwent conventional laparoscopic surgery for colorectal adenocarcinoma between November 2011 and September 2012.ResultsIn the SILS group, eleven cases (25.0%) of right hemicolectomy, 15 (34.1%) anterior resections, and 18 (40.9%) low anterior resections were performed. Additional ports were required in 10 rectal patients during SILS operation. In the 32 patients with rectosigmoid and rectal cancer in the SILS group, patients with mid and lower rectal cancers had a tendency to require a longer operation time (168.2 minutes vs. 223.8 minutes, P = 0.002), additional ports or multiport conversion (P = 0.007), than those with rectosigmoid and upper rectal cancer. Both SILS and conventional groups had similar perioperative outcomes. Operation time was longer in the SILS group than in the conventional laparoscopic surgery group (185.0 minutes vs. 139.2 minutes, P < 0.001). More diverting stoma were performed in the SILS group (64.7% vs. 24.2%, P = 0.011). Multivariate analysis showed that tumor location in the rectum (95% confidence interval [CI], 1.858-10.560; P = 0.001), SILS (95% CI, 3.450-20.233; P < 0.001), diverting stoma (95% CI, 1.606-9.288; P = 0.003), and transfusion (95% CI, 1.092-7.854; P = 0.033) were independent risk factors for long operation time (>180 minutes).ConclusionSILS is a feasible, not inferior treatment option for colorectal cancer, and appears to have similar results as standard conventional multiport laparoscopic colectomy, despite the longer operative time.

Single-incision laparoscopic surgery for colorectal cancer

“…The literature search identified one randomized contro lled trial and 13 cased-matched control or comparative studies [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] . In total, 1559 colorectal resections were included, 589 by SILC and 970 by CLC.…”

A case of single incision laparoscopic total colectomy for intestinal neuronal dysplasia type B

“…Recently, attempts to further minimize trauma related to surgical procedures and improve their cosmetic effects, especially in young patients such as the present case, resulted in modification of the laparoscopic technique to a surgical procedure with a single, a small incision, most commonly in the umbilicus, called SILS [20] , [21] . Single incision laparoscopic surgery has emerged as a new generation of laparoscopic colorectal surgery that is akin to conventional surgery, with the added benefit of better cosmesis, reduced morbidity, reduced postoperative pain, and reduced length of hospital stay, along with minimal trocar related potential complications of abdominal trauma, vessel injury, wound infection, trocar site hernia, and port-recurrences [22] . Charudutt et al described that a total colectomy by SILS is feasible and very comparable with multi-port laparoscopic colectomy in terms of length of hospital stay, operative time, and complication rates [23] .…”

Two-port laparoscopic anterior resection through a self-made glove device versus conventional laparoscopic anterior resection for rectal cancer: a comparison of short-term surgical results

“…The operating surgeon usually has a prolonged learning curve for this technique [13, 14]. In addition, the study by Lim et al found that the operative time was significantly longer for SILS than for multiport laparoscopic surgery [15]. The widespread adoption of SILS for colorectal cancer is not probable.…”