Resection of rectal cancer via an abdominal single-port access: short-term results and comparison with standard laparoscopy.

Abstract

Rectal surgery via a single-port access is complex with unknown benefits. This study aimed to compare the short-term outcome between single-port and multiport procedures. We undertook a retrospective analysis of prospectively collected data in a large, tertiary care cancer center in France. From November 2008 to June 2012, 45 patients underwent a sphincter-saving rectal resection through a single-port (n = 13) or a multiport (n = 32) approach. The single-port approach used an abdominal single port (n = 6) alone or a combined abdominal and transanal single port (n = 7). This study analyzed the morbidity, mortality, pain, and quality of the oncologic resection. The groups had a similar median operative time (290 vs 280 minutes, p = 0.54) and conversion rates (8% vs 6%, p = 0.90). No mortality occurred, and there was no difference in major morbidity (23% vs 16%, p = 0.50), anastomotic leakage (8% vs 9%, p = 1), or the length of the hospital stay (12 vs 14 days, p = 0.23). The median pain score was lower on postoperative day 2 in the single-port group (1.5 vs 4, p = 0.01). The 2 groups had similar quality criteria for oncologic resection, namely the median number of harvested lymph nodes (14 vs 15, p = 0.63), a good mesorectal dissection rate (85% vs 75%, p = 0.56), and positive resection margins (0% vs 6%, p = 0.10). This study's limitations include the retrospective nature of the data and the small number of patients. Rectal cancer surgery through a single-port access is feasible with similar outcomes and less postoperative pain than with multiport laparoscopy.