Lower rise in C-reactive protein levels, reduced OP-time and postoperative stay after single port colorectal surgery: Comparative study with multiport laparoscopy

Einleitung: The evolution from multiport to single port laparoscopic colorectal resections is getting slowly adopted in the last few years, possibly due to the learning curve needed. Impact in operative cost and postoperative stay could not be demonstrated yet. Aiming to prove advantages in operative time and postoperative stay, and inflammatory response for the new method, the present study compares in a prospective case-matched series of Single Port and multiport colorectal surgery.

Material und Methoden: Single Port (SP) colorectal resection was indicated for 39 patients with diagnosed rectal adenocarcinoma or sigmadiverticulitis, and multiport laparoscopic (MP) resection was performed in a similar set of indications by the same team in 81 cases. Prospective documentation included measure of CRP in the first 5 days, operative and postoperative parameters.

Ergebnisse: All 39 patients were submitted to SP resections without conversion to multiport laparoscopy or laparotomy. Inflamatory levels of CRP on 3 rd day for sigmoidectomy were significantly lower for SP (52,04 versus 125,5). Mean operative time was significantly lower for SP sigmoidectomy (123 min versus 148 min), but not for rectal resection with TME (189 min versus 198 min). Hospital stay was lower for SP in comparison with MP (6,6 versus 8 days). There were 2 patients with postoperative leaks for ML, and one for SP and treated by relaparoscopy or laparotomy. The postoperative course of the other patients at 30 days was uneventful.

Schlussfolgerung: The present study shows that single port sigmoidectomy can be routinely applied for colorectal resection, with advantages in operative time and postoperative stay. The less impaired CRP levels could represent less invasivity of the method. Single port surgery applied to rectal resection and TME didn't showed any advantage in the study The impact of the findings in potentially reducing hospital costs may be subject of further studies.