Does Incision Length Have Any Impact on Short Term Benefits of Laparoscopic Colon Surgery?

INTRODUCTION: With the recent introduction of hand-assist devices in laparoscopic colorectal surgery, there is renewed interest in the impact of incision length. The aim of this study is to define the impact of incision length on short-term postoperative outcomes.
METHODS: Consecutive patients undergoing laparoscopic left-sided colorectal resection by 4 surgeons from 4 different academic centers from 1991 to 2005 were retrieved from a prospectively-collected database. The association between incision length and patient characteristics, diagnosis and perioperative outcomes were analyzed, using logistic regression, Spearman correlation coefficient and Wilcoxon test.
RESULTS: 459 laparoscopic colon resection (left, sigmoid, anterior and low anterior) were retrieved. 111 patients were excluded (77 for missing data on incision length, 19 converted to open surgery, 15 with incision length ¡Ý9 cm were considered open). A total of 348 cases were included in this study. Mean incision length was 5.03±1.07 cm. The majority of operations were performed for malignant disease (n=176, 52%). Increasing weight is directly correlated with increasing incision length (p=0.0002). Mean of incision length is slightly longer in males (5.2 cm) than in females (4.85 cm, p=0.0029). Age, previous surgery, diagnosis (including malignancy) and days to discharge from hospital showed no significant relationship with incision length up to 9 cm. No association was observed between the incision length and intraoperative (p=0.25) and postoperative complications (p=0.54) using the logistic regression test.
CONCLUSION: Patients with larger extraction incision (up to 9 cm) may have the same short-term benefits of laparoscopic surgery than smaller incision group. To keep the short-term benefits of laparoscopy, surgeons should try to complete left colon surgery using minimally invasive techniques even when larger extraction incision is needed.

Session: Podium Presentation

Program Number: S015

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