Department of Surgery, Gelderse Vallei Hospital, Ede, The Netherlands.
Dig Surg. 2012;29(6):477-83. doi: 10.1159/000346044. Epub 2013 Jan 30.
Recent case studies have demonstrated the feasibility of single-incision laparoscopic colectomy (SILC). Few comparative studies for SILC and multiport laparoscopic colectomy (MLC) have been conducted. The aim of this case-controlled study was to compare the short-term surgical outcomes between SILC and MLC for right-sided colectomies.
Between January 2010 and February 2012, data from the first 50 consecutive patients that underwent right SILS at one of the two institutions were compared with a group of 50 consecutive patients that underwent right MLC in the same period.
Median operative time was significantly shorter in SILC (97 vs. 112 min; p < 0.001). Between both groups, no statistically significant differences were found regarding number and nature of short-term complications, number of reoperations [4 (8%) vs. 6 (12%)], and mortality rate [1 (2%) vs. 2 (4%)]. Median postoperative hospital stay was 6 days for both groups.
SILC is a safe and feasible procedure when performed by experienced laparoscopic surgeons. Length of hospital stay and overall complication rates are comparable with MLC. Until today, no clear advantages of SILC over MLC have been demonstrated. However, due to its smaller incisional trauma, SILC could be a major step in improving cosmetic outcomes.
最近的病例研究已经证明了单孔腹腔镜结肠切除术（SILC）的可行性。很少有关于 SILC 和多孔腹腔镜结肠切除术（MLC）的比较研究。本病例对照研究的目的是比较 SILC 和 MLC 用于右半结肠切除术的短期手术结果。
在 2010 年 1 月至 2012 年 2 月期间，对两个机构中 50 例连续接受右侧 SILS 的患者的资料与同期 50 例连续接受右侧 MLC 的患者的资料进行了比较。
SILC 的中位手术时间明显缩短（97 分钟 vs. 112 分钟；p < 0.001）。两组之间，短期并发症的数量和性质、再次手术的数量[4 例（8%）vs. 6 例（12%）]以及死亡率[1 例（2%）vs. 2 例（4%）]均无统计学差异。两组的中位术后住院时间均为 6 天。
对于有经验的腹腔镜外科医生来说，SILC 是一种安全可行的手术。住院时间和总体并发症发生率与 MLC 相当。到目前为止，SILC 尚未显示出明显优于 MLC 的优势。然而，由于其切口创伤较小，SILC 可能是改善美容效果的重要一步。
