Single port laparoscopic rectal surgery – a systematic review

INTRODUCTION

Single-port laparoscopic surgery (SPLS) for colonic disease has been widely described, whereas data for SPLS rectal resection is 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 randomized 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 on outcome. Operative times were 79-280 min. Conversion rates to conventional laparoscopic surgery and to open surgery were 12% and 2.5%, respectively. Numbers of harvested lymph nodes in malignant cases were 13-18. Post-operative complication rates were 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 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 done in a protocolled set up.

CORRESPONDENCE: Ida Lolle. E-mail: ida.lolle.01@.regionh.dk

CONFLICTS OF INTEREST: none. Disclosure forms provided by the authors are available with the full text of this article at www.danmedj.dk

REFERENCE: Dan Med J 2014;61(7):A4878