Study on the feasibility and effect of single hole laparoscopy in the radical operation of sigmoid colon and rectal cancer

Objective: To compare the effects between single hole and multi-hole laparoscopy in the radical operation of sigmoid colon and rectal cancer,and assess the feasibility of single hole laparoscopy.Methods: One hundred and twenty colorectal cancer patients during January 2014 to January 2016 were randomly divided into the single hole group and mutli-hole group using the random number table method(60 cases each group).The single hole group and mutli-hole group were treated with single hole and mutli-hole laparoscopic colorectal cancer radical operation,respectively.The intraoperative situation,postoperative recovery,complication and quality of life between two groups were compared.Results: The differences of operation time,amount of bleeding,tumor volume,distance from distal incision margin to the low margin of tumor,and number of lymph node dissection and positive lymph nodes between two groups were not statistically significant(P>0.05).The length of incision in single hole group was significantly shorter than that in multi-hole group(P<0.01).The distance from the proximal cut edge to the upper margin of tumor in single hole group was significantly longer than that in multi-hole group(P<0.01).The anus automatical exhausts time,eating liquid food time,eating solid food time and first defecating time in single hole group were significantly shorter than those in multi-hole group(P<0.01).The levels of motilin in two groups after operation decreased compared before operation(P<0.05 and P<0.01),and which in single hole group was significantly higher than that in multi-hole group(P<0.01).The postoperative VAS score,beauty index and length of stay in single hole group were significantly smaller,higher and shorter than those in multi-hole group,respectively(P<0.01).The incidence rate of early complications(including incisional infection,incision disruption,pulmonary infection,urinary tract infection and anastomotic fistula or bleeding)(3.33%) in single hole group was less than that in multi-hole group(13.33%)(P<0.05).The difference of the incidence rate of the long-term complications(including recurrence,distant metastasis and death) between two groups was not statistically significant(P>0.05).The GIQLI scores in single hole group at discharge and during the following up in single hole group were higher than that in multi-hole group(P<0.05 to P<0.01).The difference of the GIQLI scores in two groups between before and after operation were statistically significant(P<0.01),and the GIQLI scores in two groups at discharge and during the following up were significantly higher than that before operation(P<0.01).Conclusions: The single hole laparoscopy in the radical operation of sigmoid colon and rectal cancer is good effect,quick recovery,good cosmetic result,and good prognosis,which can significantly improve the quality of life of patients,and be used as one of the preferred surgical plan.