Department of Hepato-Biliary-Pancreato-Vascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China.
Dig Dis Sci. 2012 Aug;57(8):2103-12. doi: 10.1007/s10620-012-2145-0. Epub 2012 Mar 31.
Single-incision laparoscopic surgery (SILS) was developed as a novel minimally invasive surgical approach.
The aim of this meta-analysis was to compare SILS and conventional laparoscopy (CL) for colorectal diseases with respect to perioperative and oncologic outcomes.
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.
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.
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.
单切口腹腔镜手术（SILS）作为一种新型微创外科方法得到了发展。
本荟萃分析旨在比较 SILS 和传统腹腔镜（CL）治疗结直肠疾病的围手术期和肿瘤学结果。
检索了 2008 年至 2012 年间发表的比较 SILS 和 CL 治疗结直肠疾病的所有相关文章，使用 Review Manager 版本 5.0 采用固定效应或随机效应模型进行数据分析。
共发现 14 项研究（1 项随机对照试验和 13 项非随机对照试验）符合条件，并报告了 1155 例患者的资料，其中 521 例患者接受 SILS 治疗，634 例患者接受 CL 治疗。在围手术期结果方面，转换率、手术时间和术后不良事件无差异；然而，接受 SILS 的患者出血量较少、输血需求减少、肛门排气时间缩短、住院时间缩短和切口较小。在肿瘤学结果方面，两组的切除标本长度、采集的淋巴结数量、近端边缘和远端边缘无差异。
SILS 是一种安全、可行和肿瘤学有效的 CL 替代方法，适用于结直肠疾病。需要进一步进行更大规模、多中心、随机对照试验。
