Clinical and oncological outcomes of single-incision vs. conventional laparoscopic surgery for rectal cancer

Jiang, Yimei; Song, Zijia; Cheng, Xi; Liu, Kun; Shi, Yiqing; Wang, Changgang; Li, You; Ji, Xiaofan; Zhao, Ren

doi:10.1007/s00464-019-07317-5

Cited by 14 publications

(15 citation statements)

References 37 publications

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“…In addition, one duplicate not detected by the citation manager was also excluded. Thus, we reviewed the full text of 14 articles (Table I) [11][12][13][14][15][16][17][18][19][20][21][22][23][24]. Two studies by Sirikurnpiboon [11,12] had overlapping study populations, and only the most recent study was included for analysis.…”

Section: Article Search Resultsmentioning

confidence: 99%

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Single-incision versus conventional laparoscopic surgery for rectal cancer: a meta-analysis of clinical and pathological outcomes.

Kim¹,

Lee²

2022

Videosurgery and Other Miniinvasive Techniques

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Introduction: Single-incision laparoscopic surgery (SILS) for rectal cancer is technically challenging. There is a lack of high-level evidence for the feasibility and safety of SILS for rectal cancer. Aim: To compare clinical and pathological outcomes of SILS versus conventional laparoscopic surgery (CLS) for rectal cancer.Material and methods: The PubMed, Embase, CENTRAL, and Web of Science databases were searched systematically up to November 2021. Eligibility criteria included randomized controlled trials and non-randomized clinical trials that compared the outcomes of SILS and CLS for rectal cancer. Outcomes of interest included operative, postoperative, and pathologic outcomes.

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Section: Article Search Resultsmentioning

confidence: 99%

“…Finally, 3 Korean studies [21][22][23] shared the same population and included sigmoid and rectosigmoid colon cancer, and thus all 3 were excluded. After exclusions, 6 eligible studies remained for meta-analysis [11,13,14,16,17,24]. A flow diagram of the article selection is provided in Figure 1.…”

Section: Article Search Resultsmentioning

confidence: 99%

Single-incision versus conventional laparoscopic surgery for rectal cancer: a meta-analysis of clinical and pathological outcomes.

Kim¹,

Lee²

2022

Videosurgery and Other Miniinvasive Techniques

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“…The incisions were closed using an absorbable monofilament. Details of the surgical procedure were described in our previous reports ( 10 , 11 ).…”

Section: Methodsmentioning

confidence: 99%

“…Since our colorectal center performed the first single-incision laparoscopic radical resection of CRC in 2013, more than 400 single-incision laparoscopic radical resections of CRC have been performed, including right hemicolectomy, left hemicolectomy, sigmoid hemicolectomy, and high rectal surgery. Through retrospective analysis and prospective RCT research, it was confirmed that the safety and curative effects of single-incision laparoscopic radical resection of CRC are not inferior to those of traditional laparoscopic surgery (10,11).…”

Section: Introductionmentioning

confidence: 94%

Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis

et al. 2022

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BackgroundRecently, enhanced recovery after surgery (ERAS) has been widely used in the perioperative management of colorectal cancer (CRC). This study aimed to evaluate the safety and feasibility of ERAS combined with single-incision laparoscopic surgery (SILS) in CRC surgery.MethodsThis was a retrospective study of patients with CRC who underwent surgery between April 2018 and April 2020 in Ruijin Hospital(North), Shanghai Jiaotong University School of Medicine. The patients were divided into three groups: group A (n=138), patients who underwent traditional multiport laparoscopic colectomy with conventional perioperative management; group B (n=63), patients who underwent SILS; and group C (n=51), patients who underwent SILS with ERAS.ResultsOverall, 252 participants were included in the retrospective study. The median operation time (min) in group B and group C was shorter than that in group A (group A 134.0 ± 42.5; group B 117 ± 38.9; group C 111.7 ± 35.4, p=0.004). The estimated surgical blood loss (ml) was lower in groups B and C than in group A (group A 165.1 ± 142.2; group B 122.0 ± 79.4; group C 105.2 ± 55.8, p=0.011). The length of surgical incision (cm) was shorter in groups B and C than in group A (group A 7.34 ± 1.05; group B 5.60 ± 0.80; group C 5.28 ± 0.52, p<0.001). The time before first flatus (hours) in group C was shorter than in groups A and B (group A 61.85 ± 21.14; group B 58.30 ± 20.08; group C 42.06 ± 23.72; p<0.001). The days prior to the administration of free oral fluids in group C was shorter than in groups A and B (group A 4.79 ± 1.28; group B 4.67 ± 1.11; group C 2.62 ± 0.64; p<0.001). The days of prior solid diet was less in group C than in groups A and B (group A 7.22 ± 3.87; group B 7.08 ± 3.18; group C 5.75 ± 1.70; p=0.027). The postoperative length of stay (LOS) was less in group C compared with that in groups A and B (group A 9.46 ± 4.84 days; group B 9.52 ± 7.45 days; group C 7.20 ± 2.37 days; p=0.023). The visual analog scale (VAS) scores on day 0, 1, and 2 in groups B and C were lower than those in group A (day 0, p<0.001; day 1, p<0.001; day 2, p=0.002), while the VAS score on day 3 showed no differences in the three groups (group A 1.29 ± 1.38; group B 0.98 ± 1.24; group C 0.75 ± 0.64, p=0.018).ConclusionThe findings suggest that SILS combined with ERAS may be a feasible and safe procedure for CRC surgery because it provides favorable cosmetic results, early dietary resumption, shorter hospital stays, and appropriate control of postoperative pain without increases in complications or readmission rates compared to conventional perioperative care with SILS or conventional laparoscopic surgery(CLS) of CRC. Further prospective randomized controlled studies are needed to enhance evidence-based medical evidence.

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“…The closure of incisions was done by absorbable monofilament. The details of the operative procedure were described in our previous reports ( 12 , 13 ).…”

Section: Methodsmentioning

confidence: 99%

Short-Term Outcomes of Single-Incision Laparoscopic Surgery for Colorectal Cancer: A Single-Center, Open-Label, Non-Inferiority, Randomized Clinical Trial

Song

Liu

et al. 2021

Front. Oncol.

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ObjectiveTo date, well-designed randomized controlled trials examining the safety, efficacy, and long-term outcomes of single-incision laparoscopic surgery (SILS) for colorectal cancer are scarce. The aim of the current study was to compare short-term outcomes of SILS for colorectal cancer with conventional laparoscopic surgery (CLS).MethodsBetween June 28, 2017, and June 29, 2019, a single-center, open-label, non-inferiority, randomized clinical trial was conducted at the Department of General Surgery, Ruijin Hospital (North), Shanghai Jiaotong University School of Medicine in Shanghai, China. In total, 200 patients diagnosed or suspected of colorectal cancer (cT1–4aN0–2M0) were randomly assigned to either the SILS or CLS group in a 1:1 ratio. The primary outcome was early morbidity rate. Secondary outcomes included intraoperative outcomes, pain intensity, postoperative recovery, pathologic outcomes, and long-term outcomes.ResultsIn total, 193 participants (SILS, 97; CLS, 96) were analyzed in the modified intention-to-treat (MITT) population. Among them, 48 underwent right hemicolectomy (SILS n = 23, 23.7% and MLS n = 25, 26%), 15 underwent left hemicolectomy (SILS n = 6, 6.2% and MLS n = 9, 9.4%), 1 underwent transverse colectomy (MLS n = 1, 1%), 57 underwent sigmoidectomy (SILS n = 32, 33% and MLS n = 25, 26%), and 72 underwent anterior resection (SILS n = 36, 37.1% and MLS n = 36, 37.5%). No significant differences were observed in the baseline characteristics. The intraoperative complication was comparable between the two groups [5 (5.2%) vs. 4 (4.2%); difference, 1%; 95% CI, −5.8% to 7.8%; p > 0.999) and so was postoperative complication rates [10 (10.3%) vs. 14 (14.6%); difference, −4.3%; 95% CI, −13.9% to 5.3%; p = 0.392]. The SILS group showed shorter incision length [median (IQR), 4 (3.5–5) vs. 6.6 (6–7.5), p < 0.001] and lower VAS scores on the first [median (IQR), 4 (3–5) vs. 4 (4–5), p = 0.002] and the second day [median (IQR), 2 (1.5–3) vs. 3 (2–4), p < 0.001] after surgery. No statistically significant difference was found in other measured outcomes.ConclusionsCompared with CLS, SILS performed by experienced surgeons for selected colorectal cancer patients is non-inferior with good short-term safety and has the advantage of reducing postoperative pain.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT03151733.

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Clinical and oncological outcomes of single-incision vs. conventional laparoscopic surgery for rectal cancer

Cited by 14 publications

References 37 publications

Single-incision versus conventional laparoscopic surgery for rectal cancer: a meta-analysis of clinical and pathological outcomes.

Single-incision versus conventional laparoscopic surgery for rectal cancer: a meta-analysis of clinical and pathological outcomes.

Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis

Short-Term Outcomes of Single-Incision Laparoscopic Surgery for Colorectal Cancer: A Single-Center, Open-Label, Non-Inferiority, Randomized Clinical Trial

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