Bae Sung Uk, Kim Kyeong Eui, Kim Chang-Woo, Kim Ji-Hoon, Jeong Woon Kyung, Lee Yoon-Suk, Baek Seong Kyu, Lee Suk-Hwan, Kim Jun-Gi
Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Department of Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
Ann Coloproctol. 2025 Apr;41(2):154-161. doi: 10.3393/ac.2024.00563.0080. Epub 2025 Apr 29.
This study aimed to compare the wound cosmesis of a single-incision approach on scar assessment after laparoscopic surgery for colon cancer.
This study included 32 patients undergoing single-port laparoscopic surgery (SPLS) and 61 patients undergoing multiport laparoscopic surgery (MPLS) for colon cancer at 3 tertiary referral hospitals between September 2011 and December 2019. We modified and applied the Korean version of the Patient and Observer Scar Assessment Scale (POSAS) to assess cosmetic outcomes. To assess the interobserver reliability using intraclass correlation coefficient values for the Observer Scar Assessment Scale (OSAS), the surgeons evaluated 5 images of postoperative scars.
No significant differences were observed in the time before the return of normal bowel function, time to sips of water and soft diet initiation, length of in-hospital stay, and postoperative complication rate. The SPLS group had a shorter total incision length than the MPLS group. The POSAS favored the SPLS approach, revealing significant differences in the Patient Scar Assessment Scale (PSAS), OSAS, and overall scores. The SPLS approach was an independent factor influencing the POSAS, PSAS, and OSAS scores. Eleven colorectal surgeons had a significantly substantial intraclass coefficient.
The cosmetic outcomes of SPLS as assessed by the patients and surgeons were superior to those of MPLS in colon cancer. Reducing the number of ports is an independent factor affecting scar assessment by patients and observers.
本研究旨在比较结肠癌腹腔镜手术后单切口入路在瘢痕评估方面的伤口美容效果。
本研究纳入了2011年9月至2019年12月期间在3家三级转诊医院接受单孔腹腔镜手术（SPLS）的32例患者和接受多孔腹腔镜手术（MPLS）的61例结肠癌患者。我们修改并应用了韩国版的患者和观察者瘢痕评估量表（POSAS）来评估美容效果。为了使用观察者瘢痕评估量表（OSAS）的组内相关系数值评估观察者间的可靠性，外科医生评估了5张术后瘢痕图像。
在正常肠功能恢复时间、开始饮水和软食的时间、住院时间和术后并发症发生率方面未观察到显著差异。SPLS组的总切口长度比MPLS组短。POSAS更倾向于SPLS入路，在患者瘢痕评估量表（PSAS）、OSAS和总分方面显示出显著差异。SPLS入路是影响POSAS、PSAS和OSAS评分的独立因素。11位结直肠外科医生的组内系数显著较高。
患者和外科医生评估的SPLS在结肠癌中的美容效果优于MPLS。减少切口数量是影响患者和观察者瘢痕评估的独立因素。
