Z Gastroenterol 2015; 53 - KC101
DOI: 10.1055/s-0035-1559491

Ecspect multicenter results of 1769 single port colorectal procedures: Male gender, high ASA score and rectal procedures as risk factors for postoperative complications

R Zorron 1, H Weiss 2, K Vestweber 3, B Vestweber 3, L Boni 4, S Morales-Conde 5, W Brunner 6, C Sietses 7, O Bulut 8, K Gash 9, A Dixon 9
  • 1Klinikum Bremerhaven Reinkenheide, Division Innovative Chirurgie, Bremerhaven, Deutschland
  • 2SJOG Hospital 5010, Department of Surgery, Salzburg, Österreich
  • 3Klinikum Leverkusen, Department of General, Visceral and Thoracic Surgery, Leverkusen, Deutschland
  • 4Azienda Ospedaliero-Universitaria, Ospedale di Circolo Vares, Department of Surgical Sciences, Chirurgia Generale I, Varese, Italien
  • 5University Hospital „Virgen del Rocio”, Unit of Surgical Innovation in Minimally Invasive Surgery, Department of Surgery, Sevilla, Spanien
  • 6Klinikum für Chirurgie Rorschach, Department of Surgery, St Gallen, Schweiz
  • 7VU University Medical Center, Department of Surgery, Amsterdam, Niederlande
  • 8Hvidovre University Hospital Copenhagen, Department of Surgical Gastroenterology, Copenhagen, Dänemark
  • 9NHS Foundation Trust, University Hospitals Bristol, Department of Surgery, Bristol, Vereinigtes Königreich

Einleitung: Single port colorectal surgery (SPCS) is a new surgical method that, although in theory is comparable to laparoscopic techniques, published literature is scarce and current data doesn't support its indication as a valid therapeutic method. The international group ECSPECT (European Consensus of Single Port Expertise in Colorectal Treatment) was created to provide a prospective registry in experienced centers using the technique to recognize feasibility, safety, risk factors, and short term oncologic adequacy.

Material und Methoden: A prospective registry documented 1769 consecutive cases of single port colorectal resections from 9 European centers, in a four year-period. Centers were selected based on experience, defined as having more than 100 cases of SPCS. Patients signed informed consent and were able to choose between SPCS and formal laparoscopic surgery. Statistical analysis of risk factors, technique variables and short term results was performed. A statistical Risk Chart was elaborated to preview the occurrence of conversion and complications in SPCS.

Ergebnisse: SPCS was performed for 937 benign and 832 malignant underlying indications. Conversions to open surgery occurred in 4.24%. Complications occurred in 12,9%. Of these, Clavien-Dindo classified complications Type I-II occurred in 47.3%, and Type III-V in 52.7%. Death occurred in 8 patients (0.45%), surgical causes were responsible in two of them. Multivariate analysis for the Risk Chart identified that independent risk factors for conversion and complications were higher BMI, ASA 3 – 4 and lower procedures, and identified male gender, ASA 3 – 4 and lower procedures, respectively. These risk factors were confirmed in an analysis of 200 subsequent cases.

Schlussfolgerung: This largest prospective multicenter study of the literature in single port colorectal surgery identified risk factors for adequate selection criteria to safely perform single port surgery for benign and malign colorectal indications. The treatment of colorectal diseases through single port techniques proved feasible and safe among the many centers studied. Single Port Surgery is a promising new therapy besides existing laparoscopic and open surgery to improve patient care in colorectal disease.