title: Incisional hernia rate may increase after single-port cholecystectomy.
abstract: BACKGROUND
  The major concerns of single-port cholecystectomy are port-site hernia and cost. Essentially, a larger transumbilical incision is more likely to increase the incidence of incisional hernia. The effect of single-port cholecystectomy on hospital cost is controversial. This study evaluated single-port cholecystectomy and traditional four-port cholecystectomy with respect to perioperative outcomes, hospital cost, and postoperative complications.
  
  
  METHODS
  Between January 2010 and March 2011, 52 patients underwent single-port cholecystectomy, and 111 patients underwent traditional laparoscopic cholecystectomy. We used equal instruments in patients undergoing operation with the same surgical technique. Demographics, diagnosis, operative data, complications, length of hospital stay, and cost were compared between the two groups.
  
  
  RESULTS
  The patients undergoing laparoscopic cholecystectomy were significantly older than patients undergoing single-port cholecystectomy (55.8±13.8 years versus 48.7±12.7 years, P=.002). The trocar site hernia rate was 1.8% in laparoscopic cholecystectomy, and the port-site hernia rate was 5.8% in single-port cholecystectomy. This is the highest rate reported in the literature for port-site hernia following single-port cholecystectomy. Surgical techniques were not different in terms of conversion to open surgery, postoperative hospital stay, and operative time. The relative cost of single-port cholecystectomy versus laparoscopic cholecystectomy was 1.54.
  
  
  CONCLUSIONS
  Although single-port cholecystectomy seems to be a feasible surgical technique, it is not superior over the traditional laparoscopic cholecystectomy. Single-port cholecystectomy is equal to laparoscopic cholecystectomy with respect to conversion to open surgery, postoperative hospital stay, and operative time, but it is associated with high hospital cost and high port-site hernia rate.
authors.affiliation: Department of General Surgery, Selcuklu Medical School, Selcuk University , Konya, Turkey. halptekin@hotmail.com
authors.forename: Husnu
authors.initials: H
authors.lastname: Alptekin
authors.forename: Huseyin
authors.initials: H
authors.lastname: Yilmaz
authors.forename: Fahrettin
authors.initials: F
authors.lastname: Acar
authors.forename: M Ertugrul
authors.initials: ME
authors.lastname: Kafali
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sahin
mesh_terms: D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000191:economics / Q000379:methods*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery; D006555:Hernia, Ventral / Q000453:epidemiology / Q000209:etiology*; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies