Single-port laparoscopic rectal surgery - a systematic review

TY - JOUR

T1 - Single-port laparoscopic rectal surgery - a systematic review

AU - Lolle, Ida

AU - Rosenstock, Steffen

AU - Bulut, Orhan

PY - 2014/7

Y1 - 2014/7

N2 - INTRODUCTION: Single-port laparoscopic surgery (SPLS) for colonic disease has been widely described, whereas data for SPLS rectal resection are sparse. This review aimed to evaluate the feasibility, safety and complication profile of SPLS for rectal diseases.METHODS: A systematic literature search of PubMed and Embase was performed in September 2013 according to the PRISMA guidelines. Original reports on the use of SPLS in high and low anterior resection, Hartmann's operation and abdominoperineal resection were included. Outcome measures were intra-operative details and complications, short-term oncological outcome and early complication profile.RESULTS: No randomised studies or controlled clinical studies were identified. All studies were case series or case reports. Only five studies included more than ten patients operated with SPLS, comprising a total of 120 patients. These studies formed the basis for the final analyses of outcome. Operative times ranged from 79 to 280 min. Conversion rates to conventional laparoscopic surgery and to open surgery were 12% and 2.5%, respectively. The number of harvested lymph nodes in malignant cases was 13-18. The post-operative complication rate was 25.5%. Length of hospital stay was 1-16 days. No 30-day mortality was reported.CONCLUSION: Short-term results suggest that SPLS for rectal disease is feasible and safe with an acceptable complication rate when performed by experienced surgeons in selected patients. Oncological safety and the possible benefits remain to be proven. Future rectal SPLS procedures should be performed in a protocolled set-up.

AB - INTRODUCTION: Single-port laparoscopic surgery (SPLS) for colonic disease has been widely described, whereas data for SPLS rectal resection are sparse. This review aimed to evaluate the feasibility, safety and complication profile of SPLS for rectal diseases.METHODS: A systematic literature search of PubMed and Embase was performed in September 2013 according to the PRISMA guidelines. Original reports on the use of SPLS in high and low anterior resection, Hartmann's operation and abdominoperineal resection were included. Outcome measures were intra-operative details and complications, short-term oncological outcome and early complication profile.RESULTS: No randomised studies or controlled clinical studies were identified. All studies were case series or case reports. Only five studies included more than ten patients operated with SPLS, comprising a total of 120 patients. These studies formed the basis for the final analyses of outcome. Operative times ranged from 79 to 280 min. Conversion rates to conventional laparoscopic surgery and to open surgery were 12% and 2.5%, respectively. The number of harvested lymph nodes in malignant cases was 13-18. The post-operative complication rate was 25.5%. Length of hospital stay was 1-16 days. No 30-day mortality was reported.CONCLUSION: Short-term results suggest that SPLS for rectal disease is feasible and safe with an acceptable complication rate when performed by experienced surgeons in selected patients. Oncological safety and the possible benefits remain to be proven. Future rectal SPLS procedures should be performed in a protocolled set-up.

KW - Conversion to Open Surgery

KW - Feasibility Studies

KW - Humans

KW - Laparoscopy

KW - Length of Stay

KW - Lymph Node Excision

KW - Operative Time

KW - Rectal Diseases

KW - Rectal Neoplasms

M3 - Journal article

C2 - 25123124

SN - 1603-9629

VL - 61

SP - 1

EP - 6

JO - Danish Medical Journal

JF - Danish Medical Journal

IS - 7

M1 - A4878

ER -