Comparison Between Single-incision Laparoscopic And Conventional Multiport Laparoscopic In Radical Of Sigmoid Colon And Rectum Cancer

Background: With the progress of society and the stangdard ofliving,patients have been not only satisfied with curing the diseases,but also therequiring of surgical trauma and incision cosmetic results. Under the premise of safetythey are willing to treat the disease, relieve pain, reduce scarring, and even no scar.Natural Orifice Transluminal Endoscopic Surgery (NOTES) comes into being in thiscontext. In2004, the professor of Johns Hopkins University Kallo published ananimal studies about using the endoscopy into the abdominal cavity through thestomach doing liver biopsy, which put forward the concept of NOTES. But due totechnical difficulties and ethical limitations, the current majority still remain in theexperimental stage animals. As an intermediate of NOTES’s development, theSingle-Incision Laparoscopic Surgery (SILS) is highly sought after by the majority ofdoctors.It can use the the body’s natural channels in the embryonic period—navel.Compared with NOTES，SILS’s surgical scar overlap and hidden,and it can avoidinfection caused by the stomach, vagina or rectum. In terms of the equipment, SILScan use traditional laparoscopic instruments during surgery, instead of buyingexpensive specialized equipment. In terms of technology, long-term accumulation ofconventional multiport laparoscopic surgical(CMLS) technique can also be applied toSILS, instead of learning the complex surgical technology of NOTES.Objective: To compare the validity and safety of CMLS with SILS and toinvestigate the potential advantages and application value of SILC. Methods: By retrospective analysising of17cases of single-incisionlaparoscopic resection of colorectal cancer patients during2010.08～2011.12and14cases of traditional multiport laparoscopic resection of colorectal cancer patientsduring2007.02～2008.09in Zhongshan Hospital of Xiamen University, comparingthe two surgical indicators，postoperative indicators，pathological specimens andRadical indicators.To assess of the two surgical efficacy and safety.Results: Comparison of laparoscopic and conventional multiport inlaparoscopic radical resection of the sigmoid colon and colorectal cancer in operativetime (P=0.534), blood loss (P=0.480), postoperative hospital stay (P=0.060), fartfirst time after surgery (P=0.277), time to first bowel movement after surgery (P=0.917), tumor size (P=0.951), the tumor lower edge distance (P=0.562), lymph nodedissection number (P=0.844), number of positive lymph node dissection (P=0.706)the two groups were not statistically different. Comparison in the first postoperativeambulation time (P <0.05), surgical scars length (P <0.05), the upper edge of thetumor (P=0.001), the two groups were statistically different.Conclusion: SILC is safe, feasible and effective. Compared with CMLS, it hasa similar surgery. In terms of the tumor resection,SILC is restricted. Compared in thesurgical trauma, postoperative pain, postoperative cosmetic effect,SILC has moreadvantages, but requires a skilled surgeon with laparoscopic technique.