Case-mix study of single incision laparoscopic surgery (SILS) vs. Conventional laparoscopic surgery in colonic cancer resections

• Authors: Tommie Mynster , Peer Wille-Jørgensen
• Languages of publication: EN

Abstracts

EN

Single incision laparoscopic surgery (SILS) may be even less invasive to a patient than conventional laparoscopic surgery (CLS).Aim of the study of the applicability of the procedure, the first 1½ year of experiences and comparison with CLS for colonic cancer resectionsMaterial and methods. Since November 2010 SILS procedures was trained by two surgeons. Data was prospectively registered. Each of all colonic cancer resections was blindly matched with two patients operated with CLS within the period from 2009-2011 with respect of procedure, gender, T stadium, age, ASA score and BMI. In the routine accelerated “fast track” program the use of additional opioids was registered.Results. SILS was performed in 18 patients with cancer resections. Comparisons between the SILS procedures and the matched 36 CLS operations showed no significant difference in operation time, blood loss, lymph node harvest and hospital stay, but length of vascular pedicle was significantly larger in SILS procedures. Although only 50% of SILS patients received opioids postoperatively, this was not significantly different from the 71% receiving opioids in the CLS group, and similarly no significant difference in number of administrations or amount of opioids were seen.Conclusion. With reservation of a small study group we find SILS is like worthy to CLS in colorectal cancer surgery and a benefit in postoperative recovery and pain is possible, but has to be investigated in larger randomised studies

Keywords

EN

laparoscopic surgery   SILS   colonic cancer  

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2013
• Volume: 85
• Issue: 3
• Pages: 123-128

Dates

published

1 - 03 - 2013

online

20 - 04 - 2013

References

• 1. Bucher P, Pugin F, Buchs NC et al.: Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy. Br JSurg 2011; 98(12): 1695-1702.[Crossref]
• 2. Phillips MS , Marks JM, Roberts K et al.:Intermediate results of a prospective randomized controlled trial of traditional four-port laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy. Surg Endosc 2012; 26(5): 1296-1303.[Crossref]
• 3. Kim SJ, Ryu GO, Choi BJ et al.: The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer. Ann Surg 2011; 254(6): 933-40.[Crossref]
• 4. Papaconstantinou HT , Sharp N, Thomas JS: Single-incision laparoscopic right colectomy: a case-matched comparison with standard laparoscopic and hand-assisted laparoscopic techniques. J Am Coll Surg 2011; 213(1): 72-80; discussion -2.
• 5. Poon JT, Cheung CW , Fan JK et al.: Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized, controlled trial. Surg Endosc 2012; 26(10): 2729-34.[PubMed][Crossref]
• 6. Champagne BJ, Lee EC , Leblanc F et al.: Singleincision vs straight laparoscopic segmental colectomy: a case-controlled study. Dis Colon Rectum 2011; 54(2): 183-86.[Crossref][WoS]
• 7. Wolthuis AM , Penninckx F, Fieuws S, D’HooreA: Outcomes for case-matched single-port colectomy are comparable with conventional laparoscopic colectomy. Colorectal Dis 2012; 14(5): 634-41.[Crossref][WoS][PubMed]
• 8. Makino T, Milsom JW, Lee SW : Feasibility and safety of single-incision laparoscopic colectomy: a systematic review. Ann Surg 2012; 255(4): 667-76.[WoS][Crossref][PubMed]
• 9. Chen WT , Chang SC , Chiang HC et al.: Singleincision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results. Surg Endosc 2011; 25(6): 1887-92.[Crossref]
• 10. Edler D, Ohrling K, Hallstrom M et al.: The number of analyzed lymph nodes - a prognostic factor in colorectal cancer. Acta Oncol 2007; 46(7): 975-81.[WoS][Crossref]
• 11. McPartland S, Hyman N, Blaszyk H, Osler T: The number of lymph nodes in colon cancer specimens: what do the numbers really mean? ColorectalDis 2010; 12(8): 770-75.[WoS]
• 12. McNally ME , Todd Moore B, Brown KM : Singleincision laparoscopic colectomy for malignant disease. Surg Endosc 2011; 25(11): 3559-65.[Crossref]
• 13. Huscher CG, Mingoli A, Sgarzini G et al.: Standard laparoscopic versus single-incision laparoscopic colectomy for cancer: early results of a randomized prospective study. Am J Surg 2012; 204(1): 115-20.
• 14. Waters JA, Guzman MJ, Fajardo AD et al.: Single-port laparoscopic right hemicolectomy: a safe alternative to conventional laparoscopy. DisColon Rectum 2010; 53(11): 1467-72.
• 15. Ramos-Valadez DI , Patel CB , Ragupathi M et al.: Single-incision laparoscopic colectomy: outcomes of an emerging minimally invasive technique. Int J Colorectal Dis 2011; 26(6): 761-67.[Crossref]
• 16. West NP, Sutton KM , Ingeholm P et al.: Improving the quality of colon cancer surgery through a surgical education program. Dis Colon Rectum 2010; 53(12): 1594-1603.[WoS][Crossref]
• 17. Sammour T, Kahokehr A, Srinivasa S et al.: Laparoscopic colorectal surgery is associated with a higher intraoperative complication rate than open surgery. Ann Surg 2011; 253(1): 35-43.[WoS]

Identifiers

DOI

10.2478/pjs-2013-0021