ThTP4.3 Single Incision Laparoscopy (SIL) Versus Conventional Multi-port laparoscopy (CL) for Colorectal Surgery: A Systematic Review and Meta-analysis

Abstract

Abstract Background There is an increase in colorectal cancer resections worldwide and in the UK. The surgical resections were conducted open initially and replaced later with the conventional multiport technique. Laparoscopic colectomy became the standard surgical technique in 1991. With the innovation in surgical technology, single-incision laparoscopy is stated to attract more attention to the possible next step in colorectal resection. This project aimed to compare the outcome between the two techniques and detect if one technique is superior to the other. Methods According to the PRISMA guidelines, A detailed literature survey using PubMed, MEDLINE, and EMBASE databases was carried out to extract Randomised Controlled Trials published between January 2000 and May 2021 and using Revman for statistical analysis. Results Eleven RCTs were extracted with a total of 1370 with 686patients (50.07%) underwent SIL and 684pateints (49.92%) underwent CL.There was no significant difference between SIL and CL in terms of operative time (SMD=0.01; 95% CI=-0.19 to 0.22; Z= 0.11; P=0.91), length of hospital stays, (SMD= -0.10; 95% CI=-0.22 to 0.02; Z= 1.61; P=0.11), overall complication (OR=0.99; 95% CI= 0.75 to 1.30; Z=0.09; P=0.93). SIL showed shorter length incision (SMD= -0.99; 95% CI=-1.35 to -0.62; Z= 5.25; P<0.00001). SIL showed more intra operative complication (OR=1.80; 95% CI= 0.92 to 3.51; Z=1.72; P=0.09) and conversion to other technique or open (OR=3.10; 95% CI= 0.95 to 10.14; Z=1.87; P=0.06) but was not statistically significant. Conclusion SIL can be considered a safe alternative to CL if performed by experienced surgeons.