title: Comparison of single-port laparoscopy and conventional laparoscopy for extraperitoneal para-aortic lymphadenectomy.
abstract: BACKGROUND
  Extraperitoneal para-aortic lymphadenectomy (PAL) is used to treat gynecological cancers. This laparoscopic approach was first described using a multiport technique, and more recently, a single-port technique was developed. Our aim was to experimentally compare both approaches-conventional laparoscopy (CL) and single-port laparoscopy (SPL)-via the extraperitoneal laparoscopic approach.
  
  
  METHODS
  From November 2006 to July 2012, extraperitoneal PAL was performed by CL or SPL using the GelPOINT device (Applied Medical). The surgical outcomes of the 2 groups were statistically analyzed.
  
  
  RESULTS
  The study involved 69 patients; 36 underwent PAL with CL, and 33 patients underwent PAL with SPL. The mean operative times were 211.2 (range, 132-390) min and 159.6 (range, 120-255) min for the CL and SPL groups, respectively. The mean blood loss was not significantly different between the CL (52.5 mL; range, 0-100 mL) and SPL (40.5 mL; range, 0-100 mL, p = 0.62) groups. The average lymph node count was lower in the CL group (11.1; range, 4-29) compared to the SPL group (15; range, 3-19) (p = 0.03). However, this difference was not confirmed in the multivariate analysis (p = 0.16). The mean hospital stay was lower for the SPL group (2.2 days; range, 1-8 days) than the CL group (3.1 days; range, 1-5 days). In this case, the significant difference found in the univariate analysis (p = 0.02) was confirmed by the multivariate analysis (p = 0.0003). There were no conversions to open technique and no major complications.
  
  
  CONCLUSIONS
  The SPL method appears to be a feasible approach, with surgical outcomes that are not statistically different from the CL method. The cosmetic aspect, the role of SPL in decreasing postoperative pain, and its impact on hospital stay must be confirmed prospectively in larger series.
authors.affiliation: Department of Surgery, Georges-François Leclerc Cancer Center, 1 rue du Professeur Marion, 21000, Dijon, France, hudrynina@gmail.com.
authors.forename: Delphine
authors.initials: D
authors.lastname: Hudry
authors.forename: Francesco
authors.initials: F
authors.lastname: Cannone
authors.forename: Gilles
authors.initials: G
authors.lastname: Houvenaeghel
authors.forename: Max
authors.initials: M
authors.lastname: Buttarelli
authors.forename: Camille
authors.initials: C
authors.lastname: Jauffret
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Chéreau
authors.forename: Eric
authors.initials: E
authors.lastname: Lambaudie
mesh_terms: D000328:Adult; D000368:Aged; D016889:Endometrial Neoplasms / Q000473:pathology / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods; D007902:Length of Stay; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging / Q000379:methods; D061646:Operative Time; D010051:Ovarian Neoplasms / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery; D055815:Young Adult