Comparison of single-port and conventional laparoscopic abdominoperineal resection

Abstract

Background:Within the last two decades, surgical treatment of colorectal cancer has changed dramatically from large abdominal incisions to minimal access surgery. In the recent years, single port (SP) surgery has spawned from conventional laparoscopic surgery. The purpose of this study was to compare conventional with SP laparoscopic abdominoperineal resection (LAPR) for rectal cancer.Patients and Methods:This was a single-center non-randomised retrospective comparative study of prospectively collected data on 53 patients who underwent abdominoperineal resection for low rectal cancer; 41 with conventional laparoscopy and 12 with SP surgery.Results:Patients’ characteristics were in general comparable, but patients in the conventional laparoscopy-group had a significantly higher American Society of Anesthesiologists-score. The operative time was slightly shorter in the conventional laparoscopy-group, but no differences were found in oncological margins of the resected specimen, in length of stay or readmission rate.Conclusions:SP LAPR appeared to be safe and feasible in selected patients. Adequate oncologic resections can be performed with acceptable morbidity and mortality. Larger randomised controlled trials with longer follow-up are needed to determine the beneficial role of this new procedure.

Systematic review of single-incision versus conventional multiport laparoscopic surgery for sigmoid colon and rectal cancer

“…This study also contained seven English articles and two Chinese articles. All patients who underwent SILS or CLS were confirmed pathologically for sigmoid colon or rectal cancer [ 9 – 17 ] (Fig. 1 ).…”

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

“…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.…”

“…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.…”

Systematic review of single‑port vs. multi‑port surgery for rectal cancer

“…Finally, five studies were eligible in this review, which included one randomized trial and four comparative studies. All patients who underwent SPS or MPS were confirmed pathologically for rectal cancer (7)(8)(9)(10)(11). The flowchart of the selection process for studies included in this review is presented in Fig.…”

“…The operative time, blood loss and the conversion rate to open surgery were described in five studies. Levic and Bulu (9) and Nerup et al (10) reported that the operative time was significantly longer in the SPS group than in the MPS group (295 min vs. 248 min, P=0.01 and 316 min vs. 269 min, P=0.004, respectively). Sourrouille et al (11) and Levic and Bulu (9) reported that blood loss was significantly less in the SPS group than in the MPS group (100 ml vs. 200 ml, P=0.01 and 35 ml vs. 100 ml, P=0.006, respectively).…”