Application of “single-incision plus one” combined with ERAS for upper rectal and sigmoid colon cancer
1Department of Gastrointestinal Surgery, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou 350014, Fujian, China; 2Fujian Provincial Reproductive Medicine Center, Fujian Provincial Maternity and Children’s Hospital of Fujian Medical University, Fuzhou 350001, Fujian, China
Abstract： Objective To evaluate the efficacy of single-incision plus one port laparoscopic surgery (SILS+1) combined with enhanced recovery after surgery (ERAS) for upper rectal and sigmoid colon cancer. Methods A retrospective analysis on 92 cases of upper rectal and sigmoid colon cancer patients who were undergone enhanced recovery after surgery was performed. According to the different operation methods, they were divided into two groups, SILS+1 combined with ERAS group (39 patients) and conventional laparoscopic surgery (CLS) combined with ERAS group (53 patients). Then the perioperative data would be compared. Results The two groups were well balanced with respect to the baseline characteristics (P>0.05). There were no significant difference in operating time, bleeding, resection margin, number of retrieved lymph nodes and morbidity (P>0.05). However, as compared to the CLSERAS group, patients in SILS+1-ERAS group had a smaller incision [(6.7±1.1)cm vs.(8.5±1.3)cm, P=0.000], shorter time to first ambulation [(22.2±5.2)h vs. (27.1±7.9)h, P=0.001], shorter time of bowel movement [(70.2±19.8)h vs. (83.1±20.4)h, P=0.005], lower C-reaction protein in the first day [(43.5±28.6)mg/L vs. (57.2±33.2)mg/L, P=0.038] and shorter time of postoperative hospital stay [(7.0±1.7)d vs. (8.1±2.1)d, P=0.010]. Moreover, the visual analogue scale (VAS) scores were lower from 2 to 4 days after operation in SILS+1-ERAS group (P<0.05). Conclusions For experienced laparoscopic surgeons, it is safe and reproducible in single-incision plus one port laparoscopic surgery combined with ERAS for upper rectal and sigmoid colon cancer. The technical of SILS+1 could reduce the difficulty of operation and postoperative pain, promote postoperative rehabilitation. So it is worthy of clinical promotion.
