Department of Surgery, Gelderse Vallei Hospital, 6716 RP, Ede, The Netherlands.
J Gastrointest Surg. 2011 Nov;15(11):1989-94. doi: 10.1007/s11605-011-1626-3. Epub 2011 Jul 28.
Single-incision laparoscopic surgery (SILS) is one of the most recent developments in laparoscopic surgery. Having proven its effectiveness in cholecystectomy and appendectomy, the feasibility of SILS in more advanced surgery, such as hemicolectomy and low anterior resection, is now a point of discussion.
This study reports on the results of the first 50 SILS colorectal operations at our institution. Twenty right hemicolectomies, 16 sigmoid resections, 9 low anterior resections, and 5 total colectomies were performed. Nineteen patients were operated for benign colonic diseases, 31 for malignant disease.
Mean operative time was 130 min, and the median duration of postoperative hospital stay was 6 days. None of the procedures needed conversion to a laparotomy, but four patients were converted to a multiport laparoscopy. In one case, an anastomotic leakage occurred, which was treated by creating a diverting ileostomy laparoscopically. Minor complications were four wound infections and two incisional hernias.
SILS colectomy is a safe and feasible procedure even in more complex cases. Comparative studies are needed to demonstrate advantages over traditional laparoscopic surgery.
单孔腹腔镜手术（SILS）是腹腔镜手术领域的最新进展之一。在胆囊切除术和阑尾切除术方面已证明其有效性之后，SILS 在更复杂的手术（如右半结肠切除术和低位前切除术）中的可行性成为了讨论的焦点。
本研究报告了我们机构进行的前 50 例 SILS 结直肠手术的结果。共完成 20 例右半结肠切除术、16 例乙状结肠切除术、9 例低位前切除术和 5 例全结肠切除术。19 例患者因良性结肠疾病接受手术，31 例患者因恶性疾病接受手术。
平均手术时间为 130 分钟，术后住院时间中位数为 6 天。无 1 例需要转为开腹手术，但有 4 例转为多孔腹腔镜手术。有 1 例出现吻合口漏，通过腹腔镜手术造口转流治疗。有 4 例切口感染和 2 例切口疝等轻微并发症。
即使在更复杂的情况下，SILS 结肠切除术也是一种安全可行的手术。需要进行对照研究以证明其优于传统腹腔镜手术的优势。
