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Surg Innov. 2015 Feb;22(1):46-53. doi: 10.1177/1553350614529668. Epub 2014 Apr 14.

Single-access laparoscopic rectal resection versus the multiport technique: a retrospective study with cost analysis.

Author information

1
General and Mininvasive Surgical Unit, San Camillo Hospital, Trento, Italy Department of Surgical Specialities and Nephrology, University of Naples Federico II, Naples, Italy umbertobracale@gmail.com.
2
Multidisciplinary Department of Medical, Surgical and Dental Sciences, Second University of Naples, Naples, Italy.
3
General and Mininvasive Surgical Unit, San Camillo Hospital, Trento, Italy.
4
General, Laparoscopic and Robotic Surgical Unit, Monaldi Hospital, Naples, Italy.

Abstract

BACKGROUND:

Single-access laparoscopic surgery is not used routinely for the treatment of colorectal disease. The aim of this retrospective cohort study is to compare the results of single-access laparoscopic rectal resection (SALR) versus multiaccess laparoscopic rectal resection with a mean follow-up of 24 months.

METHODS:

This retrospective cohort study enrolled 42 patients. Between January 2010 and June 2012, 21 SALRs were performed. These patients were compared with a group of 21 other patients who had undergone multiport laparoscopic rectal resection. This control group had the same exclusion criteria and patient demographics. Short-term outcomes were reassessed with a mean follow-up of 2 years. Statistical analysis included the Student t test and Fisher's exact test. Finally, we performed a differential cost analysis between the 2 procedures.

RESULTS:

Exclusion criteria, patient demographics, and indication for surgery were similar in both groups. The conversion rate was 0% in both groups. There were no intraoperative complications or deaths. Bowel recovery was similar in both groups. No interventions, readmissions, or deaths were recorded at 30 days' follow-up. At a mean follow-up of 24 months, all the patients with a preoperative diagnosis of cancer are still alive and disease free. Considering the selected 3 items, the mean cost per patient for single-access laparoscopic surgery and multiple-access laparoscopic surgery were estimated as 7213 and 7495 Euros, respectively.

CONCLUSION:

We think that SALR could be performed in selected patients by surgeons with high multiport laparoscopic skills. It is compulsory by law to evaluate outcomes and cost-effectiveness by using randomized controlled trials.

KEYWORDS:

Single-incision laparoscopy; laparoscopic surgery; minimally invasive surgery; rectal resection

PMID:
24733062
DOI:
10.1177/1553350614529668
[Indexed for MEDLINE]
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