Single-incision versus multiport laparoscopic right and hand-assisted left colectomy: A case-matched comparison Journal Article
| Authors: | Lee, S. W.; Milsom, J. W.; Nash, G. M. |
| Article Title: | Single-incision versus multiport laparoscopic right and hand-assisted left colectomy: A case-matched comparison |
| Abstract: | BACKGOUND: New technology for single-incision laparoscopic colectomy is now commercially available, yet advantages of this approach over multiport laparoscopic colectomy have not been demonstrated. OBJECTIVE: This study aimed to compare the outcomes of patients who underwent single-incision vs multiport laparoscopic colectomies. DESIGN: Consecutive patients who underwent singleincision laparoscopic colectomies were case matched to patients who underwent multiport laparoscopic colectomies by age, operation, surgeon, diagnosis, and body mass index. Data from a prospective database and the medical records of patients treated were reviewed. SETTINGS: This study took place at 2 tertiary care hospitals. PATIENTS: Forty-six consecutive patients with a body mass index of 24 underwent single-incision laparoscopic colectomies (24 right, 18 sigmoid, 4 low anterior resection). MAIN OUTCOME MEASURES: Perioperative outcomes and cosmesis and body image scores at 90 days were compared. RESULTS: The largest incision length was significantly shorter for the single-incision group. Two patients with single incisions were converted to hand-assisted laparoscopic surgery and 4 required placement of a 5-mm trocar. A significantly greater portion of the operation was performed by the attending surgeons in the single-incision group. For right colectomies, operative times were similar. For left colectomies, operative time (149 ± 30 vs 126 ± 21 min) was significantly longer for the single-incision group. Time to flatus and bowel movements were significantly shorter for the single-incision group, but length of stay was similar. Cosmetic score was higher for the single-incision group (P = .03). CONCLUSIONS: Single incision is equivalent to multiport laparoscopic colectomy with regard to safety and efficacy with smaller incision size and higher cosmetic scores. Operative times were equivalent, although a greater portion of the operation was performed by the attending surgeons in the single-incision group. Further prospective studies are warranted to evaluate the advantages of single-incision laparoscopic colectomy. © The ASCRS 2011. |
| Keywords: | adolescent; adult; clinical article; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; retrospective studies; young adult; laparoscopy; laparoscopic surgery; length of stay; body mass index; operation duration; scoring system; colon resection; intermethod comparison; safety; esthetics; body image; colectomy; colonic diseases; single-incision laparoscopic surgery; incision; case-matched study; single-incision laparoscopic colectomy; hand assisted laparoscopy; multiport laparoscopic colectomy; single incision laparoscopic colectomy |
| Journal Title: | Diseases of the Colon and Rectum |
| Volume: | 54 |
| Issue: | 11 |
| ISSN: | 0012-3706 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2011-11-01 |
| Start Page: | 1355 |
| End Page: | 1361 |
| Language: | English |
| DOI: | 10.1097/DCR.0b013e31822c8d41 |
| PROVIDER: | scopus |
| PUBMED: | 21979178 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 9 December 2011" - "CODEN: DICRA" - "Source: Scopus" |
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