title: Single-Site Laparoscopic Colorectal Surgery Provides Similar Clinical Outcomes Compared With Standard Laparoscopic Surgery: An Analysis of 626 Patients.
abstract: BACKGROUND
  Compared with standard laparoscopy, single-site laparoscopic colorectal surgery may potentially offer advantages by creating fewer surgical incisions and providing a multifunctional trocar. Previous comparisons, however, have been limited by small sample sizes and selection bias.
  
  
  OBJECTIVE
  The purpose of this study was to compare 60-day outcomes between standard laparoscopic and single-site laparoscopic colorectal surgery patients undergoing elective and urgent surgeries.
  
  
  METHODS
  This was an unselected, retrospective cohort study comparing patients who underwent elective and unplanned standard laparoscopic or single-site laparoscopic colorectal resections for benign and malignant disease between 2008 and 2014. Outcomes were compared using univariate analyses.
  
  
  METHODS
  This study was conducted at a single institution.
  
  
  METHODS
  A total of 626 consecutive patients undergoing laparoscopic colorectal surgery were included.
  
  
  METHODS
  Morbidity and mortality rates within 60 postoperative days were measured.
  
  
  RESULTS
  A total of 318 (51%) and 308 patients (49%) underwent standard laparoscopic and single-site laparoscopic procedures. No significant differences were noted in mean operative time (standard laparoscopy, 182.1 ± 81.3 vs single-site laparoscopy, 177.0 ± 86.5; p = 0.30) or postoperative length of stay (standard laparoscopy, 4.8 ± 3.4 vs single-site laparoscopy, 5.5 ± 6.9; p = 0.14). Conversions to laparotomy and 60-day readmissions were also similar for both cohorts across all of the procedures performed. A significant difference was identified in the number of patients who developed postoperative complications (standard laparoscopy, 19.2% vs single-site laparoscopy, 10.7%; p = 0.004), especially with respect to surgical-site infections (standard laparoscopy, 11.3% vs single-site laparoscopy, 5.8%; p = 0.02).
  
  
  CONCLUSIONS
  This was a retrospective, single institution study.
  
  
  CONCLUSIONS
  Single-site laparoscopic colorectal surgery demonstrates similar results to standard laparoscopic colorectal surgery with regard to operative time, length of stay, and readmissions. Single-site laparoscopic colorectal surgery may provide advantages in limiting the development of certain complications, such as superficial surgical-site infections.
authors.affiliation: 1 Department of Surgery, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania 2 Department of Public Health Sciences, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania.
authors.forename: William
authors.initials: W
authors.lastname: Sangster
authors.forename: Evangelos
authors.initials: E
authors.lastname: Messaris
authors.forename: Arthur S
authors.initials: AS
authors.lastname: Berg
authors.forename: David B
authors.initials: DB
authors.lastname: Stewart
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003082:Colectomy / Q000379:methods*; D003108:Colonic Diseases / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000379:methods; D004630:Emergencies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010359:Patient Readmission / Q000706:statistics & numerical data; D012002:Rectal Diseases / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome