C Athanasiou1, A Athanasiou2, G Markides3. 1Ipswich Hospital NHS Trust, 2University of Texas, 3East Lancashire Hospitals NHS Trust
Aims: Increasing evidence suggest that CME may improve overall and disease free survival in colon cancer. Our aims were to investigate the safety and efficacy of single incision laparoscopic CME colectomy (SILCC) compared to multiport CME laparoscopic colectomy (MPCLC) providing the first meta-analytical evidence.
Methods: PUBMED, Scopus and Cochrane library were searched. Studies comparing the SILCC to MPCLC in adults with colon adenocarcinoma were included. The studies were critically appraised using the Newcastle Ottawa Scale. Statistical heterogeneity was assessed with x2 and I2. The symmetry of funnel plots was examined for publication bias.
Results: One randomized and four case control trials were included (540 SILCC Vs 609 SL). No difference was found in anastomotic leakage [OR: 0.95 (0.37, 2.43);P=0.92], post-operative ileus [OR=0.86 (0.44, 1.69);P=0.66], surgical site infection [OR=0.70 (0.35, 1.43);P=0.33], number of retrieved lymph nodes [Weighted mean difference (WMD)= 0.54 (-0.43, 1.50),P=0.28], length of hospital stay [WMD= -0.09 (-0.28, 0.11);p=0.38] and pulmonary complications [OR= 2.05 (0.28, 15.20);P=0.48]. Operative time was significantly longer in the MPCLC [WMD= -6.79 (-11.84, -1.71); P=0.008] but with a high level of heterogeneity i2= 63%.
Conclusions: The increased technical requirements of the SILCC don’t seem to increase morbidity or mortality. The equal number of lymph nodes in the two groups suggest that the extent of the dissection in the single incision group was not compromised.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87892
Program Number: P195
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster