Department of Gastroenterological Surgery, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Surg Today. 2019 Jul;49(7):621-628. doi: 10.1007/s00595-019-01777-x. Epub 2019 Feb 9.
We evaluated the perioperative inflammatory mediators in a right hemicolectomy performed with single-incision laparoscopic surgery (SILS) and traditional multi-port laparoscopic surgery (MLS) to compare the postoperative inflammatory response and feasibility of SILS with that of MLS.
In this retrospective study, we enrolled 56 consecutive colorectal cancer patients who underwent right hemicolectomy prospectively. Twenty patients underwent SILS, and 36 underwent MLS. The preoperative and postoperative levels of plasma vascular endothelial growth factor (VEGF), serum interleukin-6 (IL-6), and C-reactive protein (CRP) as well as the number of platelet cells were measured in all patients. The operation duration, number of harvested lymph nodes, length of the resected bowel, blood loss, and duration of hospital stay were also compared between the two groups.
Neither SILS nor MLS had any conversion cases. The operation duration was longer for MLS than for SILS. Blood loss tended to be lower among patients who underwent SILS than among those who underwent MLS. However, the number of harvested LNs was significantly lower with SILS than with MLS. In both pre- and postoperative blood examinations, there was no marked difference in inflammatory mediators between MLS and SILS.
There was no systemic inflammatory advantage associated with SILS compared with MLS.
我们评估了在单切口腹腔镜手术（SILS）和传统多孔腹腔镜手术（MLS）下进行右半结肠切除术时的围手术期炎症介质，以比较 SILS 与 MLS 的术后炎症反应和可行性。
在这项回顾性研究中，我们前瞻性地纳入了 56 例接受右半结肠切除术的结直肠癌患者。20 例患者接受 SILS，36 例患者接受 MLS。所有患者均测量了术前和术后血浆血管内皮生长因子（VEGF）、血清白细胞介素-6（IL-6）和 C 反应蛋白（CRP）水平以及血小板细胞数。还比较了两组之间的手术时间、采集的淋巴结数量、切除肠段的长度、出血量和住院时间。
SILS 和 MLS 均无转换病例。与 SILS 相比，MLS 的手术时间更长。SILS 组的出血量倾向于低于 MLS 组。然而，SILS 组采集的淋巴结数量明显少于 MLS 组。在术前和术后的血液检查中，MLS 和 SILS 之间的炎症介质没有明显差异。
与 MLS 相比，SILS 并没有全身性炎症优势。
