Li Fang-Han, Zeng De-Xin, Chen Li, Xu Cheng-Fei, Tan Ling, Zhang Pan, Xiao Jiang-Wei
Department of Gastrointestinal Surgery, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.
Front Oncol. 2022 Oct 13;12:997894. doi: 10.3389/fonc.2022.997894. eCollection 2022.
Single-incision laparoscopy surgery (SILS) is a new laparoscopic technique that has emerged in the past decade. Whether it has advantages over conventionl laparoscopy surgery (CLS) is inconclusive. This article aimed to compare the short- and long-term outcomes of single-incision laparoscopic surgery and conventional laparoscopic surgery for colorectal cancer through high-quality literature text mining and meta-analysis.
Relevant articles were searched on the PubMed, Embase, and Cochrane Library databases from January 2012 to November 2021. All data was from randomized controlled trials (RCTs) in order to increase the confidence of the analytical results.The main outcomes were intraoperative and postoperative complications.
A total of 10 RCTs were included, involving 1609 patients. The quality of the included studies was generally high. No significant difference was found between SILS and CLS in the postoperative complications, operation time, postoperative hospital stay, number of lymph nodes removed, readmission, reoperation, complication level I- II, complication level IIIa, complication level IIIb, prolonged Ileus, blood loss, infection, anastomotic leakage and operation time. The results showed that SILS group had a higher rate of intraoperative complications, but it had lower incision length and better cosmetic effects.
These results indicate that SILS did not have a comprehensive and obvious advantage over the CLS. On the contrary, SILS has higher intraoperative complications, which may be related to the more difficulty of SILS operation, but SILS still has better cosmetic effects, which is in line with the concept of surgical development. Therefore, the SILS needs to be selected in patients with higher cosmetic requirements and performed by more experienced surgeons.
单孔腹腔镜手术（SILS）是过去十年中出现的一种新型腹腔镜技术。它是否优于传统腹腔镜手术（CLS）尚无定论。本文旨在通过高质量文献文本挖掘和荟萃分析，比较单孔腹腔镜手术和传统腹腔镜手术治疗结直肠癌的短期和长期疗效。
在2012年1月至2021年11月期间，在PubMed、Embase和Cochrane图书馆数据库中检索相关文章。所有数据均来自随机对照试验（RCT），以提高分析结果的可信度。主要结局指标为术中及术后并发症。
共纳入10项RCT，涉及1609例患者。纳入研究的质量总体较高。在术后并发症、手术时间、术后住院时间、切除淋巴结数量、再次入院、再次手术、I-II级并发症、IIIa级并发症、IIIb级并发症、肠梗阻延长、失血、感染、吻合口漏和手术时间方面，SILS与CLS之间未发现显著差异。结果显示，SILS组术中并发症发生率较高，但切口长度较短，美容效果较好。
这些结果表明，SILS相对于CLS没有全面且明显的优势。相反，SILS术中并发症较高，这可能与SILS手术难度较大有关，但SILS仍具有较好的美容效果，这符合手术发展的理念。因此，对于有较高美容需求的患者，需要选择由经验更丰富的外科医生进行SILS手术。
