Oncologic Outcomes of Single-incision Laparoscopic Surgery Compared With Conventional Laparoscopy for Colon Cancer.

Abstract

The aim of this study is to document perioperative results and mid-term oncologic outcomes of single-incision laparoscopic (SIL) colectomy compared to conventional laparoscopic (CL) colectomy. SIL surgery is an advance in minimally invasive operative techniques and is widely accepted for various types of surgery. We prospectively collected data from 767 patients who underwent radical colectomy (250 SIL colectomy and 517 CL colectomy) between 2010 and 2011 due to primary colon cancer and retrospectively analyzed these patients with propensity score matching. Before matching, patients with CL surgery had a significantly higher percentage of comorbidities (49.2% vs 57.8%, P = 0.024). Tumor location significantly differed between 2 groups: SIL surgery was performed more frequently in patients with right colon cancer. After propensity score matching, each group included 239 patients, and there was no difference between the SIL and CL surgery groups. Estimated blood loss was more in the patients with SIL colectomy, but the rate itself of intraoperative complications was not statistically different (P = 0.662). The median follow-up period was 37 months. There were 20 recurrences in the SIL surgery group (8.4%), including 3 locoregional recurrences and 18 (7.5%) in the CL surgery group. Disease-free survival at 48 months did not differ significantly between the SIL and CL surgery groups (89.8% vs 89.9%, P = 0.548). SIL colectomy for colon cancer shows probably higher, but an acceptable complication rate and can provide resection and oncologic outcomes equal to those of CL colectomy.