Single-incision plus one-port laparoscopy surgery versus conventional multi-port laparoscopy surgery for colorectal cancer: a systematic review and meta-analysis

Int J Colorectal Dis. 2024 Apr 29;39(1):62. doi: 10.1007/s00384-024-04630-x.

Abstract

Objective: The efficacy of single-incision plus one-port laparoscopic surgery (SILS + 1) versus conventional laparoscopic surgery (CLS) for colorectal cancer treatment remains unclear. This study compares the short-term and long-term outcomes of SILS + 1 and CLS using a high-quality systematic review and meta-analysis.

Method: Literature search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, drawing from PubMed, Embase, Web of Science, and the Cochrane Library until December 10, 2023. Statistical analysis was conducted using RevMan and Stata.

Result: The review and meta-analysis included seven studies with 1740 colorectal cancer patients. Compared to CLS, SILS + 1 showed significant improvements in operation time (WMD = - 18.33, P < 0.00001), blood loss (WMD = - 21.31, P < 0.00001), incision length (WMD = - 2.07, P < 0.00001), time to first defecation (WMD = - 14.91, P = 0.009), time to oral intake (WMD = - 11.46, P = 0.04), and time to ambulation (WMD = - 11.52, P = 0.01). There were no significant differences in lymph node harvest, resection margins, complications, anastomotic leakage, hospital stay, disease-free survival, overall survival, and postoperative recurrence.

Conclusions: Compared to CLS, SILS + 1 demonstrates superiority in shortening the surgical incision and promoting postoperative recovery. SILS + 1 can provide a safe and feasible alternative to CLS.

Keywords: CLS; Laparoscopy surgery; Meta-analysis; SILS + 1; Single-incision plus one-port.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Comparative Study
  • Review

MeSH terms

  • Colorectal Neoplasms* / surgery
  • Female
  • Humans
  • Laparoscopy*
  • Length of Stay
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Operative Time
  • Postoperative Complications / etiology
  • Treatment Outcome