Case-mix study of single incision laparoscopic surgery (SILS) vs. Conventional laparoscopic surgery in colonic cancer resections
Single incision laparoscopic surgery (SILS) may be even less invasive to a patient than conventional laparoscopic surgery (CLS). Aim of the study of the applicability of the procedure, the first 1½ year of experiences and comparison with CLS for colonic cancer resections Material and methods. Since November 2010 SILS procedures was trained by two surgeons. Data was prospectively registered. Each of all colonic cancer resections was blindly matched with two patients operated with CLS within the period from 2009-2011 with respect of procedure, gender, T stadium, age, ASA score and BMI. In the routine accelerated “fast track” program the use of additional opioids was registered. Results. SILS was performed in 18 patients with cancer resections. Comparisons between the SILS procedures and the matched 36 CLS operations showed no significant difference in operation time, blood loss, lymph node harvest and hospital stay, but length of vascular pedicle was significantly larger in SILS procedures. Although only 50% of SILS patients received opioids postoperatively, this was not significantly different from the 71% receiving opioids in the CLS group, and similarly no significant difference in number of administrations or amount of opioids were seen. Conclusion. With reservation of a small study group we find SILS is like worthy to CLS in colorectal cancer surgery and a benefit in postoperative recovery and pain is possible, but has to be investigated in larger randomised studies
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