• William Sangster, Evangelos Messaris, Arthur S Berg, and David B Stewart.
• 1 Department of Surgery, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania 2 Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania.
• Dis. Colon Rectum. 2015 Sep 1; 58 (9): 862-9.

BackgroundCompared with standard laparoscopy, single-site laparoscopic colorectal surgery may potentially offer advantages by creating fewer surgical incisions and providing a multifunctional trocar. Previous comparisons, however, have been limited by small sample sizes and selection bias.ObjectiveThe purpose of this study was to compare 60-day outcomes between standard laparoscopic and single-site laparoscopic colorectal surgery patients undergoing elective and urgent surgeries.DesignThis was an unselected, retrospective cohort study comparing patients who underwent elective and unplanned standard laparoscopic or single-site laparoscopic colorectal resections for benign and malignant disease between 2008 and 2014. Outcomes were compared using univariate analyses.SettingsThis study was conducted at a single institution.PatientsA total of 626 consecutive patients undergoing laparoscopic colorectal surgery were included.Main Outcome MeasuresMorbidity and mortality rates within 60 postoperative days were measured.ResultsA total of 318 (51%) and 308 patients (49%) underwent standard laparoscopic and single-site laparoscopic procedures. No significant differences were noted in mean operative time (standard laparoscopy, 182.1 ± 81.3 vs single-site laparoscopy, 177.0 ± 86.5; p = 0.30) or postoperative length of stay (standard laparoscopy, 4.8 ± 3.4 vs single-site laparoscopy, 5.5 ± 6.9; p = 0.14). Conversions to laparotomy and 60-day readmissions were also similar for both cohorts across all of the procedures performed. A significant difference was identified in the number of patients who developed postoperative complications (standard laparoscopy, 19.2% vs single-site laparoscopy, 10.7%; p = 0.004), especially with respect to surgical-site infections (standard laparoscopy, 11.3% vs single-site laparoscopy, 5.8%; p = 0.02).LimitationsThis was a retrospective, single institution study.ConclusionsSingle-site laparoscopic colorectal surgery demonstrates similar results to standard laparoscopic colorectal surgery with regard to operative time, length of stay, and readmissions. Single-site laparoscopic colorectal surgery may provide advantages in limiting the development of certain complications, such as superficial surgical-site infections.

26 keywords...

hide…