COMMENTARY

Single Over Multiport Laparoscopic Colectomy: Only Benefit Cosmetic?

Albert B. Lowenfels, MD

Disclosures

February 19, 2019

How do the results following single-port laparoscopic surgery (SPL) compare with multiple-port laparoscopic surgery (MPL) for patients undergoing colonic surgery?

In a study, published in Annals of Surgery,[1] the authors performed a randomized controlled trial to assess the outcome in 125 patients operated for benign or malignant disease. The major endpoint, length of hospital stay adjusted for social parameters, was similar in the two groups (P = .561), as were other secondary endpoints such as duration of procedure and major or minor complication. The only significant difference was overall satisfaction with the abdominal scar; patients preferred the single-port procedure (P = .003).

Questions Remain Over Long-term Outcomes

There have been only a few published randomized trials comparing SPL with MPL for colonic surgery.[2,3,4] The results of this current study, except for patient preference for a single port, showed no difference in any of the measured outcome measures. Because follow-up was limited to 6 months, we have no information to compare SPL with MPL for cancer survival in the 36 patients with colon cancer. A larger trial with longer duration would be required to measure whether type of incision has any impact on cancer survival.

One question not answered in this manuscript concerns the likelihood of an incisional hernia, which may be higher following SPL. Until more evidence is available, it seems reasonable for surgeons to choose the approach where they had the most experience and feel most comfortable.

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