7 versus 3.3 days P < 0.02), which was also supported by another case-matched study performing right colectomies where Papaconstantinou et al. [31] reported that LOS was significantly shorter in the SILC group (n = 29) compared to LAC (n = 29) and HALC (n = 29) groups (3.4 versus 4.6 versus 4.9 days, P < 0.05). In addition, Pazopanib c-Kit maximum pain scores on p.o. Days 1 and 2 were significantly lower in the SILC group compared to LAC and HALC groups (P < 0.05). On the other hand, in comparison between 16 single-port and 27 conventional laparoscopic right hemicolectomies of similar clinical background, Waters et al. concluded that no significant difference of short-term outcomes was observed between the 2 groups [35]. Adair et al.
, in their case-matched analysis of 17 single-port and multiport laparoscopic right colectomy cases, also found similar short-term outcomes between the 2 groups [36]. Wolthuis et al., in their case-matched study between SILC (n = 14) and LAC (n = 14) examining postoperative inflammatory response, reported that C-reactive protein (CRP) levels changed similarly in both groups (P = 0.34). Table 5 Comparison of intraoperative parameters between single-incision laparoscopic colectomy and other minimally invasive surgeries. Table 6 Comparison of pathological and surgical outcomes between single-incision laparoscopic colectomy and other minimally invasive surgeries. 4. Discussion Potential advantages of SILC over other minimally invasive surgeries include a single small skin incision. The length of the skin incision is partly determined by the size of the resected specimen.
Extraction difficulties may be encountered with large colon tumors or with obese patients with thick mesentery, omentum, or deep abdominal wall and colon filled with stool. In fact, our paper revealed that the final (at the end of operation) length of incision scar was longer than the initial one in all relevant reports, suggesting that cosmetic analysis on SILC should be based on final, not initial, scar length and objectively based on cosmesis scale or body image scale which has not yet been examined in any literature. In theory, a single midline fascial incision may minimizes trauma to the abdominal muscles, epigastric articles, and parietal nerves made by multiple trocars in LAC cases.
This potentially leads to less postoperative pain and long-term additional port site complications; one out of two case-matched studies demonstrated significantly less postoperative pain score in SILC group as compared to LAC and HALS groups although another study failed to show less postoperative use of anesthesia in SILC group. When introducing any new technology, Dacomitinib one significant limitation is often the cost of the procedure. Generally, the initial increases in operative costs associated with laparoscopic techniques are mitigated by reduction in morbidity and duration of hospital stay as a result of the minimally invasive surgery.