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28.01.2020 Open Access

Single-port versus multiport laparoscopic surgery comparing long-term patient satisfaction and cosmetic outcome

Zeitschrift:: Surgical Endoscopy

Autoren:: Jonas Raakow, Denis Klein, Atakan Görkem Barutcu, Matthias Biebl, Johann Pratschke, Roland Raakow

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Abstract

Introduction

Several studies and meta-analysis showed Single-port or Single-incision laparoscopic surgery (SPL) to be superior over Multiport laparoscopic surgery (MPL) mainly in terms of postoperative pain and cosmetic result. But very little is known whether these results are only a short-term effect or are persistent on the long run after SPL. We therefore evaluated and compared long-term outcomes regarding cosmesis and chronic pain after SPL and MPL.

Methods

We conducted a comparative study with propensity score matching of all patients undergoing SPL or MPL between October 2008 and December 2013 in terms of postoperative cosmetic results and chronic pain. Follow-up data were obtained from mailed patient questionnaires and telephone interviews. Postoperative cosmesis was assessed using the patients overall scar opinion on a 10-point scale and the Patients scale of the standardized Patient and Observer Scar assessment scale (POSAS). Chronic pain was assessed by 10-point scales for abdominal and umbilical scar pain.

Results

A total of 280 patients were included in the study with 188 patients (67.1%) after SPL and 92 patients (32.9%) following MPL. 141 patients (50.4%) underwent a cholecystectomy and 139 patients (49.6%) underwent an appendectomy. The mean follow-up time was 61.1 ± 19.1 months. The mean wound satisfaction assed by the overall scar and the PSOAS Patients scale score of the patients showed no significant difference between MPL and SPL. Patients after SPL reported more overall complains than after MPL (8.7% vs. 2.5%, respectively), but without statistical significance (p = 0.321). Umbilical pain scores were comparable between the two groups (1.4 ± 1.0 vs. 1.4 ± 1.0, p = 0.831).

Conclusion

We found no difference in long-term cosmetic outcomes after SPL and MPL. Chronic pain at the umbilical incision site was comparable on the long run.

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Arezzo A, Passera R, Bullano A, Mintz Y, Kedar A, Boni L, Cassinotti E, Rosati R, Fumagalli Romario U, Sorrentino M, Brizzolari M, Di Lorenzo N, Gaspari AL, Andreone D, De Stefani E, Navarra G, Lazzara S, Degiuli M, Shishin K, Khatkov I, Kazakov I, Schrittwieser R, Carus T, Corradi A, Sitzman G, Lacy A, Uranues S, Szold A, Morino M (2017) Multi-port versus single-port cholecystectomy: results of a multi-centre, randomised controlled trial (MUSIC trial). Surg Endosc 31(7):2872–2880. https://doi.org/10.1007/s00464-016-5298-7 CrossRefPubMed

Haueter R, Schutz T, Raptis DA, Clavien PA, Zuber M (2017) Meta-analysis of single-port versus conventional laparoscopic cholecystectomy comparing body image and cosmesis. Br J Surg 104(9):1141–1159. https://doi.org/10.1002/bjs.10574 CrossRefPubMed

Lurje G, Raptis DA, Steinemann DC, Amygdalos I, Kambakamba P, Petrowsky H, Lesurtel M, Zehnder A, Wyss R, Clavien PA, Breitenstein S (2015) Cosmesis and body image in patients undergoing single-port versus conventional laparoscopic cholecystectomy: a multicenter double-blinded randomized controlled trial (SPOCC-trial). Ann Surg 262(5):728–734. https://doi.org/10.1097/SLA.0000000000001474. ( Discussion 734-725) CrossRefPubMed

Draaijers LJ, Tempelman FR, Botman YA, Tuinebreijer WE, Middelkoop E, Kreis RW, van Zuijlen PP (2004) The patient and observer scar assessment scale: a reliable and feasible tool for scar evaluation. Plast Reconstr Surg 113(7):1960–1965. https://doi.org/10.1097/01.prs.0000122207.28773.56 CrossRefPubMed

Idriss N, Maibach HI (2009) Scar assessment scales: a dermatologic overview. Skin Res Technol 15(1):1–5. https://doi.org/10.1111/j.1600-0846.2008.00327.x CrossRefPubMed

van de Kar AL, Corion LU, Smeulders MJ, Draaijers LJ, van der Horst CM, van Zuijlen PP (2005) Reliable and feasible evaluation of linear scars by the patient and observer scar assessment scale. Plast Reconstr Surg 116(2):514–522. https://doi.org/10.1097/01.prs.0000172982.43599.d6 CrossRefPubMed

Arezzo A, Passera R, Forcignano E, Rapetti L, Cirocchi R, Morino M (2018) Single-incision laparoscopic cholecystectomy is responsible for increased adverse events: results of a meta-analysis of randomized controlled trials. Surg Endosc 32(9):3739–3753. https://doi.org/10.1007/s00464-018-6143-y CrossRefPubMed

Bucher P, Pugin F, Buchs NC, Ostermann S, Morel P (2011) Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy. Br J Surg 98(12):1695–1702. https://doi.org/10.1002/bjs.7689 CrossRefPubMed

Jorgensen LN, Rosenberg J, Al-Tayar H, Assaadzadeh S, Helgstrand F, Bisgaard T (2014) Randomized clinical trial of single- versus multi-incision laparoscopic cholecystectomy. Br J Surg 101(4):347–355. https://doi.org/10.1002/bjs.9393 CrossRefPubMed

10.

Saad S, Strassel V, Sauerland S (2013) Randomized clinical trial of single-port, minilaparoscopic and conventional laparoscopic cholecystectomy. Br J Surg 100(3):339–349. https://doi.org/10.1002/bjs.9003 CrossRefPubMed

11.

Novitsky YW, Kercher KW, Czerniach DR, Kaban GK, Khera S, Gallagher-Dorval KA, Callery MP, Litwin DE, Kelly JJ (2005) Advantages of mini-laparoscopic vs conventional laparoscopic cholecystectomy: results of a prospective randomized trial. Arch Surg 140(12):1178–1183. https://doi.org/10.1001/archsurg.140.12.1178 CrossRefPubMed

12.

Olweny EO, Mir SA, Best SL, Park SK, Donnally Iii C, Cadeddu JA, Tracy CR (2012) Importance of cosmesis to patients undergoing renal surgery: a comparison of laparoendoscopic single-site (LESS), laparoscopic and open surgery. BJU Int 110(2):268–272. https://doi.org/10.1111/j.1464-410X.2011.10784.x CrossRefPubMed

13.

Bucher P, Pugin F, Ostermann S, Ris F, Chilcott M, Morel P (2011) Population perception of surgical safety and body image trauma: a plea for scarless surgery? Surg Endosc 25(2):408–415. https://doi.org/10.1007/s00464-010-1180-1 CrossRefPubMed

14.

Joseph SP, Moore BT, Slayden G, Sorensen GB, Boettger C, Potter D, Margolin D, Brown K (2013) Patient perception of single-incision laparoscopic cholecystectomy. JSLS 17(4):585–595. https://doi.org/10.4293/108680813X13693422520396 CrossRefPubMedPubMedCentral

15.

Bencsath KP, Falk G, Morris-Stiff G, Kroh M, Walsh RM, Chalikonda S (2012) Single-incision laparoscopic cholecystectomy: do patients care? J Gastrointest Surg 16(3):535–539. https://doi.org/10.1007/s11605-011-1785-2 CrossRefPubMed

16.

Perkins FM, Kehlet H (2000) Chronic pain as an outcome of surgery. A review of predictive factors. Anesthesiology 93(4):1123–1133 PubMed

17.

Blichfeldt-Eckhardt MR, Ording H, Andersen C, Licht PB, Toft P (2014) Early visceral pain predicts chronic pain after laparoscopic cholecystectomy. Pain 155(11):2400–2407. https://doi.org/10.1016/j.pain.2014.09.019 CrossRefPubMed

18.

Christoffersen MW, Helgstrand F, Rosenberg J, Kehlet H, Strandfelt P, Bisgaard T (2015) Long-term recurrence and chronic pain after repair for small umbilical or epigastric hernias: a regional cohort study. Am J Surg 209(4):725–732. https://doi.org/10.1016/j.amjsurg.2014.05.021 CrossRefPubMed

19.

Bisgaard T, Klarskov B, Trap R, Kehlet H, Rosenberg J (2002) Microlaparoscopic vs conventional laparoscopic cholecystectomy: a prospective randomized double-blind trial. Surg Endosc 16(3):458–464. https://doi.org/10.1007/s00464-001-9026-5 CrossRefPubMed

Titel: Single-port versus multiport laparoscopic surgery comparing long-term patient satisfaction and cosmetic outcome
Autoren:: Jonas Raakow
Denis Klein
Atakan Görkem Barutcu
Matthias Biebl
Johann Pratschke
Roland Raakow
Publikationsdatum: 28.01.2020
DOI: https://doi.org/10.1007/s00464-019-07351-3
Verlag: Springer US
Zeitschrift: Surgical Endoscopy And Other Interventional Techniques Official Journal of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) and European Association for Endoscopic Surgery (EAES)
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218

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Single-port versus multiport laparoscopic surgery comparing long-term patient satisfaction and cosmetic outcome

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Abstract

Introduction

Methods

Results

Conclusion

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Abstract

Introduction

Methods

Results

Conclusion

Unsere Produktempfehlungen

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Sollten Chirurgen besser nackt operieren?

Ileuspatienten adäquat versorgen: Nicht nur eine Frage des Timings

Beim lokoregionären Mammakarzinom sind Schnittränder passé

TAVI auch schon für junge Patienten?

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