ECSPECT prospective multicentre registry for single-port laparoscopic colorectal procedures

Weiß, Helmut; Zorrón, Ricardo; Vestweber, K. H.; Vestweber, Boris; Boni, Luigi; Brunner, W; Sietses, C.; Morales-Conde, Salvador; Bulut, Orhan; Gash, K; Dixon, A. R.; Mittermair, Christof; Klaus, Aline Evelin Costa; Stanger, Olaf; Weiss, Michael; Muratore, Andrea; Hell, Tobias

doi:10.1002/bjs.10315

Cited by 6 publications

(7 citation statements)

References 33 publications

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“…They recently published a retrospective study with 30 days follow-up of 1769 patients who underwent SPLS for colorectal benign and malign disease. [ 9 ] Conversion was needed in 4.2% of procedures, and was related to male patients, ASA-score over 1, and procedures involving the rectum. Data from the present study is included in the ESCPECT publication but, interestingly, we did not find any conversions in the present study.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of single-port and conventional laparoscopic abdominoperineal resection

2018

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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.

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Section: Discussionmentioning

confidence: 99%

“…However, the authors still state that large randomised trials are needed to allow any conclusions. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

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Comparison of single-port and conventional laparoscopic abdominoperineal resection

2018

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“…Experts from an international multicenter registry, the European Consensus of Single-port Expertise in Colorectal Treatment (ECSPECT) have stated that "The feasibility and safety, conversion and complication pro le demonstrated here provides guidance for patient selection" (5). The success of SILS in Europe has triggered debate about its application and transferability to other jurisdictions, including small island states, and from this has arisen recommendations for low-income countries, such as the training of local and regional healthcare providers and monitoring outcomes, which can be used for guidance in isolated communities seeking to offer SILS procedures (6).…”

Section: Introductionmentioning

confidence: 99%

Single-Port Colonic Surgery: The Bermuda Experience

Hamilton¹,

Thouet

Morton³

et al. 2022

Preprint

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BackgroundSingle Incision Laparoscopic Surgery (SILS) is attractive because it uses 1 umbilical incision for preparation and extraction of the specimen. However, the procedure is technically demanding compared to conventional laparoscopy, and it is unclear if it is possible to adopt this procedure in an isolated community like Bermuda with a small hospital.MethodsSince the introduction of SILS in Bermuda by an experienced SILS surgeon, 230 patients who underwent SILS colon procedures from 2012-2018 were reviewed. The data were analyzed according to intra- and postoperative events and outcomes. The results were compared to internationally published data.ResultsThere was a low operative time of 127.8 (40-305) minutes. There were only 4 conversions to open surgery (1.7%). The overall complication rate was 11.7% (27 patients). There were 2 postoperative deaths (0.9%). These data are within the range of internationally published data. ConclusionInitiated and guided by an experienced SILS surgeon, the adoption of single-port colon surgery in Bermuda was successful, and the SILS procedure now belongs to the standard procedures for colonic operations in Bermuda.

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“…Single-port laparoscopy (SP) is regarded as the most ambitious approach to minimize abdominal wall trauma in hepatic resection. The successful concept of aligning the entire procedure only via the incision that is necessary to retrieve the specimen has been scientifically evaluated in various organ systems such as colorectal and biliary surgeries [2,3]. In addition, the possibility to avoid vascular injury in portal hypertension by reducing the number of incisions and to alleviate repeated interventions for hepatic metastasis by preventing the formation of adhesions can be considered potential benefits in the group of these patients.…”

Section: Introductionmentioning

confidence: 99%

The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy

Mittermair

Weiss

Schirnhofer

et al. 2021

JCM

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Background: Bleeding is a negative outcome predictor in liver surgery. Reduction in the abdominal wall trauma in major hepatectomy is challenging but might offer possible benefits for the patient. This study was conducted to assess hemostasis techniques in single-port major hepatectomies (SP-MajH) as compared to multiport major hepatectomies (MP-MajH). Methods: The non-randomized study comprised 34 SP-MajH in selected patients; 14 MP-MajH served as the control group. Intraoperative blood loss and number of blood units transfused served as the primary endpoints. Secondary endpoints were complications and oncologic five-year outcome. Results: All resections were completed without converting to open surgery. Time for hepatectomy did not differ between SP-MajH and MP-MajH. Blood loss and number of patients with blood loss > 25 mL were significantly larger in MP-MajH (p = 0.001). In contrast, bleeding control was more difficult in SP-MajH, resulting in more transfusions (p = 0.008). One intestinal laceration (SP-MajH) accounted for the only intraoperative complication; 90-day mortality was zero. Postoperative complications were noted in total in 20.6% and 21.4% of patients for SP-MajH and MP-MajH, respectively. No incisional hernia occurred. During a median oncologic follow-up at 61 and 56 months (SP-MajH and MP-MajH), no local tumor recurrence was observed. Conclusions: SP-MajH requires sophisticated techniques to ensure operative safety. Substantial blood loss requiring transfusion is more likely to occur in SP-MajH than in MP-MajH.

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ECSPECT prospective multicentre registry for single-port laparoscopic colorectal procedures

Abstract: The feasibility and safety, conversion and complication profile demonstrated here provides guidance for patient selection.

Cited by 6 publications

References 33 publications

Comparison of single-port and conventional laparoscopic abdominoperineal resection

Comparison of single-port and conventional laparoscopic abdominoperineal resection

Single-Port Colonic Surgery: The Bermuda Experience

The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy

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