title: Is single-port access laparoscopy less painful than conventional laparoscopy for adnexal surgery? A comparison of postoperative pain and surgical outcomes.
abstract: OBJECTIVE
  This study aimed to compare postoperative pain and surgical outcomes after transumbilical single-port access (SPA) and conventional multiport laparoscopic surgery for adnexal lesions.
  
  
  METHODS
  A retrospective case-control study was conducted matched by age, body mass index, and frequency of previous abdominal surgery. A total of 110 SPA laparoscopy patients (cases) were matched with a cohort of 107 patients who underwent conventional laparoscopy (controls) for benign adnexal lesions. SPA system consisted of a wound retractor, surgical glove, two 5-mm trocars, and one 11-mm trocar. Postoperative pain scores were measured immediately after surgery and at 6, 24, and 48 hours postsurgery using the numerical rating scale.
  
  
  RESULTS
  Postoperative pain scores did not differ between the 2 groups (P = .552). However, higher number of painkiller administrations was observed in the SPA laparoscopy group (median 3 vs 1, P < .001). The type of surgery and intraoperative blood loss were the significant factors influencing the number of painkiller administrations after controlling for other parameters by linear regression (P < .0001). The SPA laparoscopy group had less intraoperative blood loss (45.3 vs 87.5 mL, P < .001) and shorter hospital stay (2.1 ± 0.8 vs 2.7 ± 1.0 days, P < .001) compared with the conventional laparoscopy group. Operative time and perioperative complications did not differ between groups.
  
  
  CONCLUSIONS
  There was no difference in pain intensity between the SPA and conventional laparoscopic group in this study. Future trials are warranted to better define the benefits of SPA surgery in terms of postoperative pain.
authors.affiliation: Institution of Women's Life Medical Science, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ga Won
authors.initials: GW
authors.lastname: Yim
authors.forename: Maria
authors.initials: M
authors.lastname: Lee
authors.forename: Eun Ji
authors.initials: EJ
authors.lastname: Nam
authors.forename: Sunghoon
authors.initials: S
authors.lastname: Kim
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Sang Wun
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000291:Adnexal Diseases / Q000601:surgery*; D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D016014:Linear Models; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000209:etiology*; D000267:Tissue Adhesions / Q000209:etiology; D016896:Treatment Outcome