title: Single-Incision Laparoscopy Could Be Better than Standard Laparoscopy in Right Colectomy for Cancer.
abstract: BACKGROUND
  Human natural orifice transluminal endoscopic surgery (NOTES) is slowed down by technical hurdles. Concomitantly, single-incision laparoscopy has been increasingly reported as an alternative. By reducing the invasiveness of standard laparoscopy, we may further reduce postoperative pain, decrease morbidity, preserve abdominal wall, and enhance cosmesis. Such techniques have been widely applied, including in colorectal surgery. The aim of this multicenter study is to compare the results of single-incision right colectomy (SIRC) with the results of the standard laparoscopic right colectomy (SLRC) in patients with colon cancer.
  
  
  METHODS
  The files of patients who underwent right colectomy for cancer in five hospitals between January 2010 and December 2013 have been reviewed. Exclusion criteria were open surgery, emergency setting, and American Society of Anesthesiologists (ASA) score >3. Patients were distributed in Groups A (SIRC) or B (SLRC).
  
  
  RESULTS
  Five hundred ninety-two patients were included in this study, 336 in Group A and 256 in Group B. Mean operative time was 129.0 minutes (range 65-245) in Group A and 168.1 minutes in the Group B (range 70-290), respectively (P < .001). No mortality occurred in either group. The overall 30-day morbidity rates were 21.4% in Group A and 25% in Group B, respectively (P = .64). The median length of hospital stay was 4.95 days (range 3-14) in Group A and 5.5 days in Group B (range 3-12), respectively (P = .28). Conversion to laparotomy occurred in four patients in each group (P = 1). Length of skin incision was significantly shorter in Group A than in Group B (2.99 ± 0.63 cm versus 4.94 ± 0.65 cm, P < .001). Histological analysis of the operative specimens showed no significant differences.
  
  
  CONCLUSIONS
  SIRC is feasible and sure for patients with colon cancer. As compared with SLRC, SIRC may offer some advantages, including lower operative morbidity, shorter hospital stay, and better cosmoses, without compromising the oncological quality of the resected specimen.
authors.affiliation: 1 Department of General and Minimally Invasive Surgery, Poissy/Saint-Germain Medical Center , Poissy, France .
authors.forename: Elie
authors.initials: E
authors.lastname: Chouillard
authors.affiliation: 2 Department of General Surgery, Al Amiri Hospital , Kuwait City, Kuwait .
authors.forename: Salman
authors.initials: S
authors.lastname: Alsabah
authors.affiliation: 1 Department of General and Minimally Invasive Surgery, Poissy/Saint-Germain Medical Center , Poissy, France .
authors.forename: Ronald
authors.initials: R
authors.lastname: Daher
authors.affiliation: 3 Department of Digestive Surgery, Bellevue Medical Center , Beirut, Lebanon .
authors.forename: Antoine
authors.initials: A
authors.lastname: Younan
authors.affiliation: 4 Unit of General and Minimally Invasive Surgery, La Madonnina Medical Center , Cosenza, Italy .
authors.forename: Vincenzo James
authors.initials: VJ
authors.lastname: Greco
authors.affiliation: 1 Department of General and Minimally Invasive Surgery, Poissy/Saint-Germain Medical Center , Poissy, France .
authors.forename: Elias
authors.initials: E
authors.lastname: Chahine
authors.affiliation: 1 Department of General and Minimally Invasive Surgery, Poissy/Saint-Germain Medical Center , Poissy, France .
authors.forename: Bassam
authors.initials: B
authors.lastname: Abdullah
authors.affiliation: 5 Department of General and Digestive Surgery, Saint-Joseph Hospital , Beirut, Lebanon .
authors.forename: Jean
authors.initials: J
authors.lastname: Biagini
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016896:Treatment Outcome