Comparison of Clinical Outcomes of Single-Incision Versus Conventional Multiport Laparoscopic Distal Pancreatectomy: A Single Institution Experience
Orhan Agcaoglu1, Nihat Aksakal2, İbrahim Fethi Azamat2, Selim Doğan2, Selçuk Mercan2, Umut Barbaros21Department of General Surgery, Koc University Faculty of Medicine, Istanbul, Turkey2Department of General Surgery, Istanbul University Faculty of Medicine, Istanbul, Turkey
Objectives: Single-incision laparoscopic procedures have been gaining popularity in recent years due to their minimal incisional morbidity and improved cosmetic outcomes. Herein, we will compare the feasibility and outcomes of single-incision and conventional multiport laparoscopic distal pancreatectomy.
Methods: This study involves consecutive patients who underwent either single-incision or conventional multiport laparoscopic distal pancreatectomy from March 2007 to February 2014. The patients were divided into two groups, based on the surgical approach: single-incision laparoscopic surgery (Group 1) and conventional multiport laparoscopic surgery (Group 2). The parameters evaluated included estimated blood loss, operative time, postoperative pain, duration of hospital stay, complications, conversion, and final pathology.
Results: There were a total of 20 patients, 10 in each study group. Baseline characteristics were similar, and there was no mortality in either of the groups. The low-flow pancreatic fistula was the most commonly seen morbidity, but it was ceased spontaneously in each group by a ratio of 30%. The operative time was significantly shorter in Group 2, with a mean of 116 minutes versus a mean of 180 minutes for Group 1 (p<0.001). One of the procedures in Group 2 was converted to open surgery due to peroperative bleeding. The median follow-up periods of the patients were 22 months and 56 months. The spleen was preserved in only 1 patient from Group 1, whereas in Group 2, the spleen preservation was achieved in 5 patients.
Conclusion: The single-incision laparoscopic technique is a safe and effective alternative to standard laparoscopic distal pancreatectomy.
Comparison of Clinical Outcomes of Single Incision versus Conventional Multi-Port Laparoscopic Distal Pancreatectomy: A Single Institution Experience
Orhan Agcaoglu1, Nihat Aksakal2, İbrahim Fethi Azamat2, Selim Doğan2, Selçuk Mercan2, Umut Barbaros21Department of General Surgery, Koc University Faculty of Medicine, Istanbul, Turkey2Department of General Surgery, Istanbul University Faculty of Medicine, Istanbul, Turkey
Son yillarda ozellikle insizyona bagli morbiditenin daha az olmasi ve daha iyi kozmetik sonuclar sebebiyle tek kesiden yapilan laparoskopik cerrahi islemlerinin popularite artmistir. Bu calismamizda tek kesi ile coklu kesiden yapilan laparoskopik distal pankreatektomi ameliyatlarinin uygulanabilirligini ve sonuclarini karsilastirmayi amacladik. Yontem: Calismamiza Mart 2007 ile Subat 2014 tarihleri arasinda klinigimizde ardisik olarak tek kesiden ve coklu kesiden laparoskopik distal pankreatektomi ameliyati yapilmis olan hastalarimizi dahil ettik. Hastalarimizi cerrahi teknige uygun olarak tek kesiden (grup 1) ve coklu kesiden (grup 2) laparoskopik distal pankreatektomi yapilan hastalar olmak uzere iki gruba ayirdik. Karsilastirmada ameliyat suresi, ameliyat sonrasi agri, hastanede yatis suresi, komplikasyonlar, aciga gecis orani, tahmini kanama miktari ve patoloji sonuclarini degerlendirdik. Bulgular: Calismada her grupta 10 hasta olmak uzere toplam 20 hasta mevcuttu. Gruplar arasi hasta profilleri benzerdi ve her iki grupta da mortalite yoktu. En sik gorulen morbidite, iki gruptada spontan iyilesen dusuk debili pankreas fistuluydu (%30). Ameliyat suresi, 2. grupta 1. gruba gore istatistiksel olarak daha kisa olculdu (p<0.001). Grup 2'de 1 hastada peroperatif kanama sebebiyle acik teknige gecildi. Grup 1'de sadece bir vakada dalak korunabilirken, grup 2'de bes vakada korundu. Sonuc: Tek kesiden yapilan laparoskopik teknik, standart olarak coklu kesiden uyguanan laparoskopik distal pankreatektomi ile benzer sonuclar saglamaktadir ve ileri laparoskopi uygulanan merkezlerde guvenle tercih edilebilir.
Anahtar Kelimeler: Tek kesiden laparoskopik cerrahi, Laparoskopik cerrahi; Pankreas rezeksiyonu; Laparoskopik distal pankreatektomi; Minimal invaziv cerrahiManuscript Language: English