North Bristol NHS Trust, Bristol, UK.
Colorectal Dis. 2013 Mar;15(3):329-33. doi: 10.1111/j.1463-1318.2012.03178.x.
Single-incision laparoscopic surgery (SILS) is gaining momentum. The aim of the present study was to compare the outcome of SILS for high anterior resection with that of standard laparoscopic resection (StdLS).
Patients undergoing laparoscopic high anterior resection were prospectively entered into an institutional approved database. Patients treated with SILS were compared with those undergoing StdLS.
Between April 2000 and April 2009, 327 (143 cancer) consecutive unselected patients underwent StdLS; there were three (1%) conversions and 12 (3.6%) covering ileostomies. After April 2009, 55 (29 cancer) consecutive, unselected patients underwent SILS; there were two conversions to a three-port technique (3.6%), no conversions to open resection and two (3.6%) covering ileostomies. There were no significant differences in age, sex, body mass index, hospital of operation or American Society of Anesthesiology (ASA) grade between the two groups. The operating time for SILS was significantly shorter (113 ± 44 min for StdLS vs 79 ± 37 min for SILS; P < 0.0001). SILS patients tolerated a normal diet earlier [10 (2-24) h for SILS vs 18 (2-96) h for StdLS] and were discharged faster [1 (1-8) days for SILS vs 3 (1-24) days for StdLS]. There were no significant differences in return to theatre, readmissions or 30-day mortality.
SILS for high anterior resection is feasible, safe and quicker to perform than standard three-port laparoscopic colectomy. It seems to be associated with a faster recovery and earlier discharge.
单切口腹腔镜手术（SILS）正在兴起。本研究旨在比较 SILS 与标准腹腔镜手术（StdLS）治疗高位前切除术的结果。
前瞻性地将接受腹腔镜高位前切除术的患者纳入机构批准的数据库中。将接受 SILS 治疗的患者与接受 StdLS 治疗的患者进行比较。
2000 年 4 月至 2009 年 4 月，327 例（143 例癌症）连续未经选择的患者接受了 StdLS；有 3 例（1%）转为三孔技术，12 例（3.6%）行预防性回肠造口术。2009 年 4 月后，55 例（29 例癌症）连续未经选择的患者接受了 SILS；有 2 例（3.6%）转为三孔技术，无中转开腹，2 例（3.6%）行预防性回肠造口术。两组间在年龄、性别、体重指数、手术医院或美国麻醉医师协会（ASA）分级方面无显著差异。SILS 的手术时间明显缩短（StdLS 为 113±44min，SILS 为 79±37min；P<0.0001）。SILS 患者更早耐受正常饮食[10（2-24）h 用于 SILS 与 18（2-96）h 用于 StdLS]，更快出院[SIL 为 1（1-8）d，StdLS 为 3（1-24）d]。两组在再次手术、再入院或 30 天死亡率方面无显著差异。
SILS 治疗高位前切除术是可行的、安全的，并且比标准三孔腹腔镜结肠切除术更快。它似乎与更快的恢复和更早的出院相关。
