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Surgical Endoscopy

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01-11-2015

Does single port improve results of laparoscopic colorectal surgery? A propensity score adjustment analysis

Authors: Antoine Khayat, Léon Maggiori, Eric Vicaut, Marianne Ferron, Yves Panis

Published in: Surgical Endoscopy | Issue 11/2015

Abstract

Background

The benefit of single-incision laparoscopy (SIL) over conventional multiport laparoscopy (ML) is not demonstrated in colorectal surgery, mainly because of potentially biased reports. The objective of this study was to compare SIL to ML for colorectal resection, using a propensity score (PS) adjusted analysis.

Methods

From July 2009 to April 2013, 764 patients who underwent 799 colorectal resections by SIL or ML were analyzed. PS was estimated using a logistic regression model.

Results

Eighty-four colorectal resections were performed using SIL: 43 ileocolic resections, 15 right-sided colectomies, 14 left-sided colectomies, 5 rectal resections, 4 subtotal colectomies, and 3 total proctocolectomies. Intra-operative complications occurred in 3 procedures (4 %), and conversion laparotomy in 10 (12 %). Postoperative mortality was nil and overall morbidity rate was 25 %, including 7 % of major complications. Mean postoperative length of hospital stay was 8 ± 6 (4–47) days. Outcomes of SIL, when compared to those of 715 ML and after PS adjustment, showed no difference in terms of intra-operative complication (p = 0.315), conversion to open surgery (p = 0.387), overall morbidity (p = 0.393), major morbidity (p = 0.381), or length of postoperative hospital stay (p = 0.080). However, the length of hospital stay was significantly shorter after SIL in the right colectomy subgroup (p = 0.001).

Conclusions

In colorectal surgery, SIL appears to be safe and effective as compared to ML. It can also reduce hospital stay after right colectomy. These results, if confirmed by randomized trials, would validate SIL in colorectal surgery.

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Title: Does single port improve results of laparoscopic colorectal surgery? A propensity score adjustment analysis
Authors: Antoine Khayat
Léon Maggiori
Eric Vicaut
Marianne Ferron
Yves Panis
Publication date: 01-11-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 11/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4063-7

At a glance: The STEP trials

Springer Medicine

Does single port improve results of laparoscopic colorectal surgery? A propensity score adjustment analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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