title: Single-incision versus conventional laparoscopic sigmoid colectomy: a case-matched series.
abstract: BACKGROUND
  Single-incision laparoscopic surgery is an emerging modality that has proven to be safe and feasible for colon resection in multiple case reports and series. Nonetheless, comparative analyses with established techniques are limited in the published literature. We evaluated the efficacy of single-incision laparoscopic colectomy (SILC) for the treatment of sigmoid disease through a matched-case comparison with conventional laparoscopic colectomy (CLC).
  
  
  METHODS
  Twenty patients who underwent single-incision laparoscopic sigmoid resection for benign or malignant disease between July 2009 and September 2010 were matched to patients who underwent conventional laparoscopic sigmoid colectomy. Demographic, intraoperative, and postoperative data were assessed.
  
  
  RESULTS
  Twenty SILC and CLC cases each were paired based on gender (p < 1.0), age (p < 0.47), pathology (p < 1.0), and surgical procedure (p < 1.0). Ten patients (50%) in the SILC group and eight patients (40%) in the CLC group had a history of prior abdominal surgery (p < 0.53). There were no conversions to open surgery; however, one SILC procedure (5%) required conversion to CLC (p < 0.31). There was no significant difference in mean operating time between groups (p < 0.80). Mean estimated blood loss was significantly lower for SILC compared to CLC (p < 0.007). Mean lymph node extraction was comparable between groups in the subset of patients with malignant disease (p < 0.68). Two postoperative complications were encountered in each group. The mean length of hospital stay for SILC and CLC was 3.2 ± 1.0 and 3.8 ± 2.1 days, respectively (p < 0.25). There were no readmissions or reoperative interventions in either group.
  
  
  CONCLUSIONS
  Compared with conventional laparoscopic technique, single-incision laparoscopic surgery results in similar intraoperative and postoperative outcomes. The technique avoids use of multiple trocar sites and may safely be performed in patients with a history of previous abdominal surgery while maintaining a short length of hospital stay and low complication rate.
authors.affiliation: Division of Minimally Invasive Colon and Rectal Surgery, Department of Surgery, University of Texas Medical School at Houston, 7900 Fannin Street, Suite 2700, Houston, TX 77054, USA.
authors.forename: Diego I
authors.initials: DI
authors.lastname: Ramos-Valadez
authors.forename: Madhu
authors.initials: M
authors.lastname: Ragupathi
authors.forename: Javier
authors.initials: J
authors.lastname: Nieto
authors.forename: Chirag B
authors.initials: CB
authors.lastname: Patel
authors.forename: Steven
authors.initials: S
authors.lastname: Miller
authors.forename: T Bartley
authors.initials: TB
authors.lastname: Pickron
authors.forename: Eric M
authors.initials: EM
authors.lastname: Haas
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D003082:Colectomy / Q000379:methods*; D012809:Colon, Sigmoid / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012810:Sigmoid Diseases / Q000601:surgery*; D016896:Treatment Outcome