Single-port versus conventional multi-port laparoscopic surgery in the treatment of colorectal cancer: A systematic review and meta-analysis

Abstract

Objective: To compare the clinical efficacy of single-port laparoscopic surgery (SILS) and conventional multi-port laparoscopic surgery (CMLS) in the treatment of colorectal cancer.Methods: A systematic literature search was performed in Pubmed, Embase, Cochrane library, Web of science and ClinicalTrials.gov. Randomized controlled trials (RCTs) studies comparing SILS and CMLS for colorectal cancer (CRC) were enrolled. Quality assessment was performed using the Cochrane Collaboration’s risk of bias tool. Meta-analysis was performed using Review Manager 5.4.1.Results: Eight RCTs with a total of 1143 patients were finally included. The results of meta-analysis showed that the incision length of SILS group was shorter than that of CMLS group in radical resection of CRC [P = 0.003, MD = -2.64, 95% CI (-4.39, -0.89)], the tumor size in pathological specimens of SILS group was smaller than that of CMLS group [P = 0.008, MD = 0.12, 95% CI (0.03, 0.22)]; while the operation time, intraoperative blood loss, conversion rate, postoperative first anus exhaust time, postoperative first day rest pain score, hospital stay, incidence of postoperative complications, incidence of reoperation, number of dissected lymph nodes, length of pathological specimens, distance from the distal resection margin of the tumor and distance from the proximal resection margin of the tumor was not statistically different between SILS and CMLS.Conclusion: SILS is feasible and safe in the treatment of colorectal cancer, and may be more advantageous in terms of cosmetic results. Long-term outcomes need to be confirmed by larger RCTs with complete follow-up data.