ECSPECT prospective multicentre registry for single-port laparoscopic colorectal procedures

TY - JOUR

T1 - ECSPECT prospective multicentre registry for single-port laparoscopic colorectal procedures

AU - Weiss, Helmut

AU - Zorron, R

AU - Vestweber, K-H

AU - Vestweber, Boris

AU - Boni, L

AU - Brunner, W.

AU - Sietses, C

AU - Morales-Conde, S

AU - Bulut, O

AU - Gash, K

AU - Dixon, A R

AU - Mittermair, C

AU - Klaus, A

AU - Stanger, O

AU - Weiss, M

AU - Muratore, A

AU - Hell, T

AU - ECSPECT Study Group

N1 - © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: The international multicentre registry ECSPECT (European Consensus of Single Port Expertise in Colorectal Treatment) was established to evaluate the general feasibility and safety of single-port colorectal surgery with regard to preoperative risk assessment. Methods: Consecutive patients undergoing single-port colorectal surgery were enrolled from 11 European centres between March 2010 and March 2014. Data were analysed to assess patient-, technique- and procedure-dependent parameters. A validated sex-adjusted risk chart was developed for prediction of single-port colorectal surgery-related conversion and complications. Results: Some 1769 patients were enrolled, 937 with benign and 832 with malignant conditions. Procedures were completed without additional trocars in 1628 patients (92·0 per cent). Conversion to open surgery was required in 75 patients (4·2 per cent) and was related to male sex and ASA fitness grade exceeding I. Conversions were more frequent in pelvic procedures involving the rectum compared with abdominal procedures (8·1 versus 3·2 per cent; odds ratio 2·69, P < 0·001). Postoperative complications were observed in a total of 224 patients (12·7 per cent). Independent predictors of complications included male sex (P < 0·001), higher ASA grade (P = 0·006) and rectal procedures (P = 0·002). The overall 30-day mortality rate was 0·5 per cent (8 of 1769 patients); three deaths (0·2 per cent; 1 blood loss, 2 leaks) were attributable to surgical causes. Conclusion: The feasibility and safety, conversion and complication profile demonstrated here provides guidance for patient selection.

AB - Background: The international multicentre registry ECSPECT (European Consensus of Single Port Expertise in Colorectal Treatment) was established to evaluate the general feasibility and safety of single-port colorectal surgery with regard to preoperative risk assessment. Methods: Consecutive patients undergoing single-port colorectal surgery were enrolled from 11 European centres between March 2010 and March 2014. Data were analysed to assess patient-, technique- and procedure-dependent parameters. A validated sex-adjusted risk chart was developed for prediction of single-port colorectal surgery-related conversion and complications. Results: Some 1769 patients were enrolled, 937 with benign and 832 with malignant conditions. Procedures were completed without additional trocars in 1628 patients (92·0 per cent). Conversion to open surgery was required in 75 patients (4·2 per cent) and was related to male sex and ASA fitness grade exceeding I. Conversions were more frequent in pelvic procedures involving the rectum compared with abdominal procedures (8·1 versus 3·2 per cent; odds ratio 2·69, P < 0·001). Postoperative complications were observed in a total of 224 patients (12·7 per cent). Independent predictors of complications included male sex (P < 0·001), higher ASA grade (P = 0·006) and rectal procedures (P = 0·002). The overall 30-day mortality rate was 0·5 per cent (8 of 1769 patients); three deaths (0·2 per cent; 1 blood loss, 2 leaks) were attributable to surgical causes. Conclusion: The feasibility and safety, conversion and complication profile demonstrated here provides guidance for patient selection.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Colon

KW - Colonic Diseases

KW - Conversion to Open Surgery

KW - Europe

KW - Feasibility Studies

KW - Female

KW - Humans

KW - Laparoscopy

KW - Male

KW - Middle Aged

KW - Postoperative Complications

KW - Prospective Studies

KW - Rectal Diseases

KW - Rectum

KW - Registries

KW - Sex Factors

KW - Young Adult

KW - Journal Article

KW - Observational Study

U2 - 10.1002/bjs.10315

DO - 10.1002/bjs.10315

M3 - Journal article

C2 - 27762435

SN - 0007-1323

VL - 104

SP - 128

EP - 137

JO - British Journal of Surgery

JF - British Journal of Surgery

IS - 1

ER -