Single-incision versus conventional laparoscopic colectomy for colonic neoplasm: a randomized, controlled trial

Surgical Endoscopy, 05/01/2012

In a selected group of patients with small tumor and good operative risk, single–incision laparoscopic colectomy (SILC) is a safe alternative to conventionally laparoscopic colectomy (CLC). Single–port laparoscopic colectomy also is associated with the benefits of less postoperative pain and shorter hospital stay than CLC.

Methods

  • Patients who had small cancer (<4 cm) or adenomatous polyp requiring colectomy were randomized to have SILC or CLC.
  • The patients were blinded to the procedures and the postoperative pain was used as the primary outcome measure.
  • All patients had patient–controlled analgesia with intravenous morphine after the operation and the nominal rating score on days 1–3 and day 14 were recorded by research staff, who did not known the types of operations.
  • Other operative outcomes of the two groups of patients also were recorded prospectively and compared.

Results

  • There were 25 patients in each group.
  • The patients’ demographics, tumor characteristics, operating time, blood loss, complication rate, number of lymph nodes harvested, and resection margin have no statistically significant difference between the two groups.
  • There was no operative mortality in both groups.
  • The SILC group had consistently lower median pain score than CLC group in the whole postoperative course and the difference was statistically significant on day 1 (0 (0–5) vs. day 3 (0–6) respectively; p = 0.002) and day 2 (0 (0–3) vs. 2 (0–8) respectively; p = 0.014).
  • The median hospital stay in the SILC group also was shorter the CLC group.

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