Comparison between the perioperative results of single-access and conventional laparoscopic surgery in rectal cancer.

INTRODUCTION

Laparoscopic surgery for rectal cancer has low rates of morbidity and mortality and achieves comparable pathologic outcomes. With improved instruments and surgical techniques, many surgeons have recently begun using single-access laparoscopic surgery (SALS) to minimize scars and pain. Since 2011, most reports of SALS for rectal cancer have shown comparable pathologic outcomes to those of conventional laparoscopic surgery (CLS). However, SALS is said to be superior to CLS in reducing complications, producing less discomfort, and faster recovery rates. This study aimed to compare the technical feasibility and early postoperative outcomes of these approaches.

METHODS

From January 2011 to January 2014, 78 cases of adenocarcinoma of the rectum and anal canal were enrolled in the study. Anterior, low anterior, intersphincteric, and abdominoperineal resections were performed. Data collected included technical feasibility and outcomes of operation, such as morbidity, mortality, severity of pain, analgesic usage, and length of hospital stay.

RESULTS

SALS was performed on 35 patients, and CLS was performed in 36 cases. Demographic data, including age, sex, BMI, ASA classification and clinical staging, were similar between the groups. Operative time, blood loss, and conversion rate were similar (P > 0.05). Postoperatively, the only significant difference between the groups was pain score, which was significantly lower in the SALS group (P < 0.001).

CONCLUSION

SALS and CLS for rectal and anal cancer had the same intraoperative, pathologic, and early postoperative results. However, SALS patients had slightly better pain scores in the first 24 and 48 h postoperatively.