University Hospital of North Tees, Hardwick, Stockton-on-Tees, TS19 8PE, UK.
Tech Coloproctol. 2012 Dec;16(6):423-8. doi: 10.1007/s10151-012-0839-0. Epub 2012 May 22.
Single-port access (SPA) offers cosmetic advantages in addition to the well-recognised benefits of conventional multi-port laparoscopic (CL) surgery, and can be carried out using standard straight instruments. We report the outcomes of our early experience with SPA colorectal resections in comparison with CL surgery.
We compared the following data, patient characteristics, operating time, morbidity, operative mortality, length of hospital stay and tumour variables, of patients who underwent SPA right, left, sigmoid and total colon resections, as well as high anterior resections and panproctocolectomies, with that of patients who underwent equivalent conventional laparoscopic (CL) operations. The 40 SPA and 78 CL patients studied underwent surgery between February 2008 and September 2011.
There was no difference between the SPA and CL operations, as regards the patient's sex (55.0 vs. 62.8% males, p = 0.411), comorbidity (ASA I 10.0 vs. 12.8%; ASA II 57.5 vs. 59.0%; ASA III 32.5 vs. 25.6%; ASA IV 0 vs. 2.6%, p = 0.722) and body mass index (26.2 vs. 28.0 kg/m(2), p = 0.073). However, SPA patients were younger (mean age 54.1 vs. 64.8 years, p = 0.001), and malignancy was a less common indication for surgery (25.0 vs. 71.8%, p < 0.001). There were no conversions to open surgery, and one death occurred in the CL group (1.3%). Mean operating time (162 vs. 170 min, p = 0.547), median post-operative hospital stay (4 vs. 4 days, p = 0.255) and morbidity (7.5 vs. 12.8%, p = 0.538) were comparable.
SPA laparoscopic surgery appears safe in the hands of experienced laparoscopic surgeons, with no increase in operating time, length of stay, morbidity and mortality. Selection of patients with indications for surgery for benign disease may be of importance to ensure an oncologically safe initial uptake of SPA colorectal practice.
单孔通道（SPA）除了常规多孔腹腔镜（CL）手术的公认优势外，还具有美容优势，并且可以使用标准直器械进行。我们报告了 SPA 结直肠切除术的早期经验，将其与 CL 手术进行了比较。
我们比较了以下数据，患者特征，手术时间，发病率，手术死亡率，住院时间和肿瘤变量，在 SPA 右，左，乙状结肠和全结肠切除术以及高前切除术和全直肠结肠切除术的患者中，以及接受等效常规腹腔镜（CL）手术的患者。在 2008 年 2 月至 2011 年 9 月之间，40 例 SPA 和 78 例 CL 患者接受了手术。
SPA 和 CL 手术之间，患者性别（男性 55.0%与 62.8%，p = 0.411），合并症（ASA I 10.0%与 12.8%；ASA II 57.5%与 59.0%；ASA III 32.5%与 25.6%；ASA IV 0%与 2.6%，p = 0.722）和体重指数（26.2 与 28.0 kg/m（2），p = 0.073）无差异。但是，SPA 患者年龄较小（平均年龄 54.1 与 64.8 岁，p = 0.001），并且手术的恶性指征较少（25.0%与 71.8%，p <0.001）。没有转为开放手术，CL 组有 1 例死亡（1.3%）。平均手术时间（162 与 170 分钟，p = 0.547），中位术后住院时间（4 与 4 天，p = 0.255）和发病率（7.5%与 12.8%，p = 0.538）相似。
经验丰富的腹腔镜外科医生进行 SPA 腹腔镜手术是安全的，不会增加手术时间，住院时间，发病率和死亡率。选择具有良性疾病手术指征的患者可能对确保 SPA 结直肠实践的初始安全性至关重要。
