Abstract
To compare postoperative pain along with other surgical outcomes after transumbilical single port access (SPA) and conventional multiport laparoscopic surgery for adnexal lesions. Retrospective case-control study matched by age, body mass index, and frequency of previous abdominal surgery. Division of Gynecologic Oncology, Severance Hospital, South Korea – A Tertiary center. One hundred ten SPA laparoscopy patients (cases) were matched with a cohort of 107 patients that underwent conventional laparoscopy (controls) between October 2007 and May 2010. SpA system consisted of a wound retractor, surgical glove, two 5-mm trocars, and one 11-mm trocar. Postoperative pain scores were measured using the numerical rating scale. Postoperative pain scores did not differ between the two groups (P = .552). However, higher number of painkiller administration was observed in the SPA laparoscopy group (median 3 vs. 1, P < .001). Linear mixed model analysis showed no difference in pain intensity between the two groups over time (P = .440). The type of surgery and intraoperative blood loss were the significant factors influencing the number of painkiller administration after controlling for other parameters by linear regression (P < .0001). The SPA laparoscopy group had less intraoperative blood loss (45.3 mL vs. 87.5 mL, P < .001) and similar hospital stay (2.1 ± 0.8 vs. 2.7 ± 1.0 days, P < .001) compared with the conventional laparoscopy group. Operative time and perioperative complications did not differ between groups. Despite the common expectation that minimally invasive surgery may harbor less postoperative pain, there was no statistical difference in pain intensity between the SPA and conventional laparoscopic group in this study. Although SPA laparoscopy is a feasible method for adnexectomies with comparable surgical outcomes, future trials are warranted to better define the benefits of SPA surgery in terms of postoperative pain.
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