title: The application of McBurney's single-incision laparoscopic colectomy alleviates the response of patients to postoperative wound pain.
abstract: BACKGROUND
  Single-incision laparoscopic colectomy (SILC) is one of several promising operation choices. Our previous study demonstrated that SILC with a self-made glove-port system both improves the feasibility of SILC and decreases the cost expense of surgery. Because the incision site for SILC could be made at either the umbilicus or McBurney's point, we are interested in whether the incision site affects the outcomes of patients, which is a less explored topic. The purpose of this study is not only to show the results of SILC with a self-made glove-port system for supporting its feasibility, but also to compare the short-term surgical outcomes between SILC with the incision made at the umbilicus and at McBurney's point.
  
  
  METHODS
  We collected and reviewed the medical records of patients who received SILC with a self-made glove-port system for tumors in the left side of the colon from August 2009 to March 2011. All operations were performed by a single surgeon. Comparisons of the demographic characteristics, perioperative data, and clinical outcomes between umbilical and McBurney's SILCs were performed. Postoperative pain was assessed by a visual analog scale and opiate demand.
  
  
  RESULTS
  In total, 61 patients were enrolled in this retrospective study. Five of 48 (10.4%) tumors in the umbilical SILC group and 5 of 13 (38.5%) tumors in the McBurney's SILC group were located below the peritoneal reflection. The tumor location was significantly different between these two groups (P=.015). Patients in the umbilical SILC group had significantly higher frequency of opiate demand than those in the McBurney's SILC group (0.4±0.7 versus 1.4±1.8, respectively; P=.002).
  
  
  CONCLUSIONS
  This study further provides evidence for supporting the safety and feasibility of SILC in treating colorectal diseases. More important is that McBurney's SILC not only alleviates the patient response to wound pain, but also provides the same site for a diverting enterostomy to avoid creating an additional wound.
authors: 1 Department of Trauma and Emergency Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine , Kaohsiung, Taiwan .
authors: Wei-Hung
authors: WH
authors: Lai
authors: Yueh-Ming
authors: YM
authors: Lin
authors: Ko-Chao
authors: KC
authors: Lee
authors: Hong-Hwa
authors: HH
authors: Chen
authors: Yun-Ju
authors: YJ
authors: Chen
authors: Chien-Chang
authors: CC
authors: Lu
mesh_terms: D000005:Abdomen; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D012189:Retrospective Studies; D014472:Umbilicus
chemical_list: D000701:Analgesics, Opioid