Comparative Analysis Of Single-incision Laparoscopic Plus One And Conventional Laparoscopic Radical Resection For Colorectal Carcinoma

Objective: To assess the feasibility,safety,curative effect and advantages of single-incision laparoscopic plus one surgery（SILS+1）in the radical resection of colorectal carcinoma.Methods: Clinical data were collected from 56 patients who underwent for sigmoid colon or middle-high position rectal carcinoma in the Department of Gastrointestinal Surgery,Minda Hospital of Hubei Minzu University from January 2016 to October 2021 and retrospectively analyzed.According to the different surgical approach.the patients were divided into 2 groups,including 25 cases of single-incision laparoscopic plus one group（SILS+1 group）,another 31 cases of conventional five-port laparoscopic group（CLS group）.Comparing The basic information,preoperative CEA,intraoperative blood loss,intraoperative complications,operation time,number of lymph node dissections,postoperative recovery,oncology and pathology information were compared between the two groups.Results: 1.The visual analogue scale pain scores of patients in the SILS+1 group were（2.64±0.50）and（2.04±0.20）on the second and third day after surgery,respectively,which were lower than those of the CLS group（3.08±0.49）and（2.56±0.50）at the same time,and the differences were statistically significance（P<0.05）.2.In terms of intraoperative indicators,the mean operative times of patients in the SILS+1 and CLS groups were（186.4 ± 56.87）min and（213.88 ± 58.76）min,respectively（P>0.05）,and the mean intraoperative bleeding volumes were（152.60±78.01）ml and（155.60±229.91）ml（P>0.05）,and the intraoperative lymph node dissection numbers were（11.80±2.17）and（11.36±2.75）,respectively（P>0.05）The differences were not statistically significant.In the CLS group,one patient was transferred to open abdomen surgery because of the large intraoperative bleeding and the difficulty in operating under the lumpectomy to stop the bleeding.3.In both groups,the patients’ general condition,ASA classification,carcinoembryonic antigen,past medical history,tumor TNM stage,VAS score on the day of surgery and the first day after surgery,time of first drink,time of liquid diet,time of semi-liquid diet,total hospital stay,postoperative complications,tumor size,proximal and distal margins There were no statistically significant differences in tumor differentiation and postoperative chemotherapy（P>0.05）.Conclusion: single-incision laparoscopic plus one surgery has the same short-term clinical results and less postoperative pain than conventional laparoscopic surgery.Therefore,its application to radical colorectal carcinoma surgery is safe,feasible and worth promoting.