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Single-Incision Versus Conventional Laparoscopy for Colorectal Disease: A Meta-Analysis

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Abstract

Background

Single-incision laparoscopic surgery (SILS) was developed as a novel minimally invasive surgical approach.

Aims

The aim of this meta-analysis was to compare SILS and conventional laparoscopy (CL) for colorectal diseases with respect to perioperative and oncologic outcomes.

Methods

An electronic search was performed to retrieve all relevant articles published in the English language between 2008 and 2012 comparing SILS and CL for colorectal diseases. The data were analyzed with fixed-effect or random-effects models using review manager version 5.0.

Results

A total of 14 studies (one randomized controlled trial and 13 nonrandomized controlled trials) were found to be eligible and reported on 1,155 subjects, of whom 521 underwent SILS and 634 underwent CL for colorectal diseases. Concerning the perioperative outcomes, no differences were observed in conversion rate, operating time, and postoperative adverse events; however, patients who underwent SILS had lower blood loss, decreased blood transfusion requirement, shorter time to flatus, shorter hospital stay, and smaller incision. Concerning the oncologic outcomes, length of resected specimens, number of harvested lymph nodes, proximal margin, and distal margin, were comparable between two groups.

Conclusions

Single-incision laparoscopic surgery (SILS) is a safe, feasible, and oncological efficient alternative to CL for colorectal diseases. Further larger, multi-centred, randomised controlled trial is indicated.

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References

  1. Aziz O, Constantinides V, Tekkis PP, et al. Laparoscopic versus open surgery for rectal cancer: a meta-analysis. Ann Surg Oncol. 2006;13:413–424. doi:10.1245/ASO.2006.05.045.

    Article  PubMed  Google Scholar 

  2. Veenhof AA, Sietses C, von Blomberg BM, et al. The surgical stress response and postoperative immune function after laparoscopic or conventional total mesorectal excision in rectal cancer: a randomized trial. Int J Colorectal Dis. 2011;26:53–59. doi:10.1007/s00384-010-1056-9.

    Article  PubMed  CAS  Google Scholar 

  3. Lai EC, Yang GP, Tang CN, Yih PC, Chan OC, Li MK. Prospective randomized comparative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy. Am J Surg. 2011;202:254–258. doi:10.1016/j.amjsurg.2010.12.009.

    Article  PubMed  Google Scholar 

  4. Lakdawala MA, Muda NH, Goel S, Bhasker A. Single-incision sleeve gastrectomy versus conventional laparoscopic sleeve gastrectomy—a randomised pilot study. Obes Surg. 2011;21:1664–1670. doi:10.1007/s11695-011-0478-y.

    Article  PubMed  Google Scholar 

  5. Raakow R, Jacob DA. Initial experience in laparoscopic single-port appendectomy: a pilot study. Dig Surg. 2011;28:74–79. doi:10.1159/000322921.

    Article  PubMed  Google Scholar 

  6. Nguyen NT, Hinojosa MW, Smith BR, Reavis KM. Single laparoscopic incision transabdominal (SLIT) surgery-adjustable gastric banding: a novel minimally invasive surgical approach. Obes Surg. 2008;18:1628–1631. doi:10.1007/s11695-008-9705-6.

    Article  PubMed  Google Scholar 

  7. Koyanagi T, Motomura S. Transumbilical single-incision laparoscopic surgery: application to laparoscopically assisted vaginal hysterectomy. Arch Gynecol Obstet. 2011;83:305–309. doi:10.1007/s00404-010-1358-8.

    Article  Google Scholar 

  8. Bucher P, Pugin F, Morel P. Single port access laparoscopic right hemicolectomy. Int J Colorectal Dis. 2008;23:1013–1016. doi:10.1007/s00384-008-0519-8.

    Article  PubMed  Google Scholar 

  9. Merchant AM, Lin E. Single-incision laparoscopic right hemicolectomy for a colon mass. Dis Colon Rectum. 2009;52:1021–1024. doi:10.1007/DCR.0b013e3181a4fabe.

    Article  PubMed  Google Scholar 

  10. Gaujoux S, Bretagnol F, Ferron M, Panis Y. Single-incision laparoscopic colonic surgery. Colorectal Dis. 2011;13:1066–1071. doi:10.1111/j.1463-1318.2010.02404.x.

    Article  PubMed  CAS  Google Scholar 

  11. Adair J, Gromski MA, Lim RB, Nagle D. Single-incision laparoscopic right colectomy: experience with 17 consecutive cases and comparison with multiport laparoscopic right colectomy. Dis Colon Rectum. 2010;53:1549–1554. doi:10.1007/DCR.0b013e3181e85875.

    Article  PubMed  Google Scholar 

  12. Waters JA, Guzman MJ, Fajardo AD, et al. Single-port laparoscopic right hemicolectomy: a safe alternative to conventional laparoscopy. Dis Colon Rectum. 2010;53:1467–1472. doi:10.1007/DCR.0b013e3181f23ca0.

    Article  PubMed  Google Scholar 

  13. Chen WT, Chang SC, Chiang HC, et al. Single-incision laparoscopic versus conventional laparoscopic right hemicolectomy: a comparison of short-term surgical results. Surg Endosc. 2011;25:1887–1892. doi:10.1007/s00464-010-1481-4.

    Article  PubMed  Google Scholar 

  14. Champagne BJ, Lee EC, Leblanc F, Stein SL, Delaney CP. Single-incision versus straight laparoscopic segmental colectomy: a case–controlled study. Dis Colon Rectum. 2011;54:183–186. doi:10.1007/DCR.0b013e3181fd48af.

    Article  PubMed  CAS  Google Scholar 

  15. Kim SJ, Ryu GO, Choi BJ, et al. The short-term outcomes of conventional and single-port laparoscopic surgery for colorectal cancer. Ann Surg. 2011;254:933–940. doi:10.1097/SLA.0b013e318237826b.

    Article  PubMed  Google Scholar 

  16. Gaujoux S, Maggiori L, Bretagnol F, Ferron M, Panis Y. Safety, feasibility, and short-term outcomes of single port access colorectal surgery: a single institutional case-matched study. J Gastrointest Surg. 2011;16:629–634. doi:10.1007/s11605-011-1780-7.

  17. Lee SW, Milsom JW, Nash GM. Single-incision versus multiport laparoscopic right and hand-assisted left colectomy: a case-matched comparison. Dis Colon Rectum. 2011;54:1355–1361. doi:10.1097/DCR.0b013e31822c8d41.

    Article  PubMed  Google Scholar 

  18. Papaconstantinou HT, Sharp N, Thomas JS. Single-incision laparoscopic right colectomy: a case-matched comparison with standard laparoscopic and hand-assisted laparoscopic techniques. J Am Coll Surg. 2011;213:72–80. doi:10.1016/j.jamcollsurg.2011.02.010.

    Article  PubMed  Google Scholar 

  19. Papaconstantinou HT, Thomas JS. Single-incision laparoscopic colectomy for cancer: assessment of oncologic resection and short-term outcomes in a case-matched comparison with standard laparoscopy. Surgery. 2011;150:820–827. doi:10.1016/j.surg.2011.07.060.

    Article  PubMed  Google Scholar 

  20. Huscher CG, Mingoli A, Sgarzini G, et al. Standard laparoscopic versus single-incision laparoscopic colectomy for cancer: early results of a randomized prospective study. Am J Surg. 2011. (Epub ahead of print). doi:10.1016/j.amjsurg.2011.09.005.

  21. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12.

    Article  PubMed  CAS  Google Scholar 

  22. Athanasiou T, Al-Ruzzeh S, Kumar P, et al. Off-pump myocardial revascularization is associated with less incidence of stroke in elderly patients. Ann Thorac Surg. 2004;77:745–753. doi:10.1016/j.athoracsur.2003.07.002.

    Article  PubMed  Google Scholar 

  23. Lu CC, Lin SE, Chung KC, Rau KM. Comparison of clinical outcome of single incision laparoscopic surgery using a simplified access system with conventional laparoscopic surgery for malignant colorectal disease. Colorectal Dis. 2011;14:e171–e176. doi:10.1111/j.1463-1318.2011.02825.x.

  24. Fujii S, Watanabe K, Ota M, et al. Single-incision laparoscopic surgery using colon-lifting technique for colorectal cancer: a matched case-control comparison with standard multiport laparoscopic surgery in terms of short-term results and access instrument cost. Surg Endosc. 2011. (Epub ahead of print). doi:10.1007/s00464-011-2047-9.

  25. Champagne BJ, Papaconstantinou HT, Parmar SS, et al. Single-incision versus standard multiport laparoscopic colectomy: a multicenter, case–controlled comparison. Ann Surg. 2012;255:66–69. doi:10.1097/SLA.0b013e3182378442.

    Article  PubMed  Google Scholar 

  26. Ramos-Valadez DI, Ragupathi M, Nieto J, et al. Single-incision versus conventional laparoscopic sigmoid colectomy: a case-matched series. Surg Endosc. 2012;26:96–102. doi:10.1007/s00464-011-1833-8.

    Article  PubMed  Google Scholar 

  27. Rijcken E, Mennigen R, Argyris I, Senninger N, Bruewer M. Single-incision laparoscopic surgery for ileocolic resection in Crohn’s disease. Dis Colon Rectum. 2012;55:140–146. doi:10.1097/DCR.0b013e31823d0e0d.

    Article  PubMed  Google Scholar 

  28. Markar SR, Karthikesalingam A, Thrumurthy S, Muirhead L, Kinross J, Paraskeva P. Single-incision laparoscopic surgery (SILS) versus conventional multiport cholecystectomy: systematic review and meta-analysis. Surg Endosc. 2011. (Epub ahead of print). doi:10.1007/s00464-011-2051-0.

  29. Hashizume M, Sugimachi K. Needle and trocar injury during laparoscopic surgery in Japan. Surg Endosc. 1997;11:1198–1201. doi:10.1007/s004649900568.

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

The authors declared no potential competing interests.

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Authors and Affiliations

  1. Department of Hepato–Biliary–Pancreato–Vascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China

    Yan-Ming Zhou, Lu-Peng Wu, Dong-Hui Xu & Bin Li

  2. Department of Health Statistics, Second Military Medical University, Shanghai, China

    Yan-Fang Zhao

Authors
  1. Yan-Ming Zhou
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  2. Lu-Peng Wu
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  3. Yan-Fang Zhao
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  4. Dong-Hui Xu
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  5. Bin Li
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Correspondence to Bin Li.

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Zhou, YM., Wu, LP., Zhao, YF. et al. Single-Incision Versus Conventional Laparoscopy for Colorectal Disease: A Meta-Analysis. Dig Dis Sci 57, 2103–2112 (2012). https://doi.org/10.1007/s10620-012-2145-0

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  • DOI: https://doi.org/10.1007/s10620-012-2145-0

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