David B Stewart1, Evangelos Messaris. 1. Department of Surgery, Division of Colon and Rectal Surgery, M. S. Hershey Medical Center, The Pennsylvania State University, 500 University Drive, Mail Code H 137, P.O. Box 850, Hershey, PA 17033, USA. dstewart@hmc.psu.edu
Abstract
BACKGROUND: Single-site laparoscopy (SSL) represents an innovation whose wider adoption may be limited by technical challenges and a current dearth of outcomes data. METHODS: A retrospective review of prospectively collected data was performed on all consecutive laparoscopic colorectal resections, including elective and emergent surgeries. Patient demographics and operative details were collected, and outcomes were analyzed for 30 days following surgery. RESULTS: Forty-one single-site laparoscopic procedures were performed, with 12 (29%) being nonelective. Surgeries included seven right colectomies, eight sigmoidectomies, four ileocolectomies, five total colectomies, two low anterior resections, and two abdominoperineal resections. The most frequent indication for surgery was inflammatory bowel disease (31.7%), followed by cancer (24.4%) and diverticular disease (24.4%). Thirty-seven percent of the patients had undergone previous abdominal surgery, with 64% of these having undergone previous laparotomy. One (2.5%) patient required conversion to multiple trocar laparoscopy, and five (12%) required conversion to laparotomy. Mean length of hospital stay was 4.2 days for SSL without a conversion. There was one anastomotic leak, no postoperative bleeding, no surgical site infections, and no deaths. The readmission rate was 14%. CONCLUSIONS: SSL is safe when applied to unselected patients undergoing colorectal surgery, including those patients who have undergone a previous laparotomy.
BACKGROUND: Single-site laparoscopy (SSL) represents an innovation whose wider adoption may be limited by technical challenges and a current dearth of outcomes data. METHODS: A retrospective review of prospectively collected data was performed on all consecutive laparoscopic colorectal resections, including elective and emergent surgeries. Patient demographics and operative details were collected, and outcomes were analyzed for 30 days following surgery. RESULTS: Forty-one single-site laparoscopic procedures were performed, with 12 (29%) being nonelective. Surgeries included seven right colectomies, eight sigmoidectomies, four ileocolectomies, five total colectomies, two low anterior resections, and two abdominoperineal resections. The most frequent indication for surgery was inflammatory bowel disease (31.7%), followed by cancer (24.4%) and diverticular disease (24.4%). Thirty-seven percent of the patients had undergone previous abdominal surgery, with 64% of these having undergone previous laparotomy. One (2.5%) patient required conversion to multiple trocar laparoscopy, and five (12%) required conversion to laparotomy. Mean length of hospital stay was 4.2 days for SSL without a conversion. There was one anastomotic leak, no postoperative bleeding, no surgical site infections, and no deaths. The readmission rate was 14%. CONCLUSIONS: SSL is safe when applied to unselected patients undergoing colorectal surgery, including those patients who have undergone a previous laparotomy.
Authors: Ruben Veldkamp; Esther Kuhry; Wim C J Hop; J Jeekel; G Kazemier; H Jaap Bonjer; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio M Lacy Journal: Lancet Oncol Date: 2005-07 Impact factor: 41.316
Authors: Celia N Robinson; G John Chen; Courtney J Balentine; Shubhada Sansgiry; Christy L Marshall; Daniel A Anaya; Avo Artinyan; Daniel Albo; David H Berger Journal: Ann Surg Oncol Date: 2011-01-07 Impact factor: 5.344