Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
Department of Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
Surg Endosc. 2018 Mar;32(3):1540-1549. doi: 10.1007/s00464-017-5842-0. Epub 2017 Sep 15.
Single-port laparoscopic surgery (SPLS) was recently introduced as an innovative minimally invasive surgery method. Retrospective studies have revealed the safety and feasibility of SPLS for colon cancer treatment. However, no prospective randomized trials have been performed. The multicenter, randomized SIMPLE (single-port versus multiport laparoscopic surgery) trial aimed to investigate short-term perioperative outcomes of SPLS for colon cancer treatment, compared with multiport laparoscopic surgery (MPLS).
Between August 2011 and April 2014, a total of 194 patients with colon cancer were recruited from seven hospitals in Korea. Patients were randomly allocated into the SPLS group (n = 99) or MPLS group (n = 95). The primary endpoint was postoperative complications. Operative, postoperative, and pathologic outcomes were analyzed after 50% of the patient study population had been recruited.
The patients' demographic characteristics, operative times, estimated blood volume losses, numbers of harvested lymph nodes, and lengths of both resection margins were not significantly different between groups. In the SPLS group, the rates of conversion to MPLS and open surgery were 12.9 and 2.2%, respectively. Postoperative complications occurred in 10.8% of the SPLS, and 12.5% of the MPLS patients (p = 0.714). Times to functional recovery, pain scores, and amounts of analgesia were similar between groups.
The results of this interim analysis suggested that SPLS is technically safe and appropriate when used for radical resection of colon cancer. (ClinicalTrials.gov Identifier: NCT01480128).
单孔腹腔镜手术(SPLS)最近作为一种创新的微创手术方法被引入。回顾性研究已经证实了 SPLS 在结肠癌治疗中的安全性和可行性。但是,目前尚未开展前瞻性随机试验。这项多中心、随机的 SIMPLE(单孔与多孔腹腔镜手术)试验旨在研究 SPLS 治疗结肠癌的短期围手术期结果,并与多孔腹腔镜手术(MPLS)进行比较。
2011 年 8 月至 2014 年 4 月,共从韩国的 7 家医院招募了 194 例结肠癌患者。患者被随机分配到 SPLS 组(n=99)或 MPLS 组(n=95)。主要终点是术后并发症。在招募了 50%的患者后,对手术、术后和病理结果进行了分析。
两组患者的人口统计学特征、手术时间、估计失血量、采集的淋巴结数量以及两个切除边缘的长度均无显著差异。在 SPLS 组,中转 MPLS 和开腹手术的比例分别为 12.9%和 2.2%。SPLS 组的术后并发症发生率为 10.8%,MPLS 组为 12.5%(p=0.714)。两组患者的功能恢复时间、疼痛评分和镇痛药用量相似。
中期分析结果表明,SPLS 用于结肠癌根治性切除是安全可行的。(临床试验注册号:NCT01480128)。