title: Single-incision laparoscopic right colectomy: a case-matched comparison with standard laparoscopic and hand-assisted laparoscopic techniques.
abstract: BACKGROUND
  Single-incision laparoscopic (SIL) colectomy is an advance in minimally invasive colorectal surgical techniques. Feasibility and safety of SIL colectomy has been reported; however, benefits and outcomes are not well-defined. The purpose of this study was to compare outcomes of SIL right colectomy with multiport laparoscopic (LAP) and hand-assisted laparoscopic (HAL) techniques.
  
  
  METHODS
  SIL right colectomy cases performed between August 2009 and April 2010 were case-matched for age, sex, body mass index, American Society of Anesthesiologists score, previous abdominal surgery, and pathology to an equivalent number of LAP and HAL right colectomy cases. Data analyzed included operative time, procedure conversion, incision length, length of hospital stay, 30-day hospital readmission, surgical site infection and maximum postoperative pain score.
  
  
  RESULTS
  Twenty-nine patients were analyzed in each of 3 groups (SIL, LAP, and HAL). The mean age (p = 0.96), body mass index (p = 0.48), American Society of Anesthesiologists score (p = 0.74), and rate of previous abdominal operation (p = 0.95) were similar, and sex and pathology were identical among groups. Operative time and conversion rates were similar. The incision length for SIL (4.5 cm) and LAP (5.1 cm) groups was similar, and both were significantly shorter than HAL group (7.2 cm; p < 0.001). Length of hospital stay was 3.4 days for the SIL group and was more than 1-day shorter than LAP and HAL groups (p < 0.05). Postoperative surgical site infection and hospital readmission were similar among groups. Maximum pain score on postoperative days 1 and 2 was significantly lower in SIL group (p < 0.05).
  
  
  CONCLUSIONS
  SIL right colectomy can improve patient recovery through a decrease in early postoperative pain and shorter length of hospital stay when compared with established laparoscopic techniques.
authors.affiliation: Department of Surgery, Section of Colon and Rectal Surgery, Scott & White Memorial Hospital and Clinic, Texas A&M University System Health Science Center College of Medicine, Temple, TX 76508, USA. hpapaconstantinou@swmail.sw.org
authors.forename: Harry T
authors.initials: HT
authors.lastname: Papaconstantinou
authors.forename: Nicole
authors.initials: N
authors.lastname: Sharp
authors.forename: J Scott
authors.initials: JS
authors.lastname: Thomas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods*; D003108:Colonic Diseases / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome