A 3 mm Port Reduces Postoperative Pain After Laparoscopic Colon Cancer Surgery : A Case-control Matched Study
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc..
BACKGROUND: Recently, smaller-size trocars and instruments have been developed for laparoscopic colon cancer surgery; however, their effectiveness and safety have not been elucidated. This study aimed to investigate whether 3 mm trocars and instruments have benefits compared with conventional trocars and instruments.
PATIENTS AND METHODS: Patients with colon cancer who underwent laparoscopic anterior resection or right hemicolectomy were included. Patients who underwent combined resections of other organs and those with conversion to open surgery were excluded. In the 3 mm group, three 5 mm trocars were replaced by 3 mm trocars. The numeric rating scale (NRS) immediately postoperatively at 24, 48, and 72 hours, respectively, after surgery and the use of additional analgesics and perioperative outcomes were analyzed. Case-control matched analysis was used to reduce bias according to the type of surgery.
RESULTS: A total of 207 patients (conventional: n = 158, 3 mm: n = 49) were included. Before matching, NRS 48 hours postoperatively ( P = 0.049), proportion of patients using additional intravenous (IV) analgesics ( P = 0.007), postoperative hospital stay ( P < 0.001), and blood loss ( P < 0.001) were lower in the 3 mm group. In multivariable analysis, trocar type significantly impacted the proportion of patients using additional IV analgesics (odds ratio: 0.330; 95% CI: 0.153-0.712; P = 0.005). After case-control matching, NRS immediately postoperatively ( P = 0.015) and 24 hours postsurgery ( P = 0.043), patients using additional IV analgesics ( P = 0.019), postoperative hospital stay ( P = 0.010), intraoperative blood loss ( P < 0.001), and postoperative complication rate ( P = 0.028) were significantly lower in the 3 mm group compared with the 5 mm group.
CONCLUSIONS: The use of 3 mm trocars and instruments in laparoscopic colon cancer surgery can effectively reduce postoperative pain while maintaining perioperative safety.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
Surgical laparoscopy, endoscopy & percutaneous techniques - 33(2023), 6 vom: 01. Dez., Seite 596-602 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Choi, Jin Sun [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 07.12.2023 Date Revised 07.12.2023 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1097/SLE.0000000000001218 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM362226369 |
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| 100 | 1 | |a Choi, Jin Sun |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A 3 mm Port Reduces Postoperative Pain After Laparoscopic Colon Cancer Surgery |b A Case-control Matched Study |
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| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. | ||
| 520 | |a BACKGROUND: Recently, smaller-size trocars and instruments have been developed for laparoscopic colon cancer surgery; however, their effectiveness and safety have not been elucidated. This study aimed to investigate whether 3 mm trocars and instruments have benefits compared with conventional trocars and instruments | ||
| 520 | |a PATIENTS AND METHODS: Patients with colon cancer who underwent laparoscopic anterior resection or right hemicolectomy were included. Patients who underwent combined resections of other organs and those with conversion to open surgery were excluded. In the 3 mm group, three 5 mm trocars were replaced by 3 mm trocars. The numeric rating scale (NRS) immediately postoperatively at 24, 48, and 72 hours, respectively, after surgery and the use of additional analgesics and perioperative outcomes were analyzed. Case-control matched analysis was used to reduce bias according to the type of surgery | ||
| 520 | |a RESULTS: A total of 207 patients (conventional: n = 158, 3 mm: n = 49) were included. Before matching, NRS 48 hours postoperatively ( P = 0.049), proportion of patients using additional intravenous (IV) analgesics ( P = 0.007), postoperative hospital stay ( P < 0.001), and blood loss ( P < 0.001) were lower in the 3 mm group. In multivariable analysis, trocar type significantly impacted the proportion of patients using additional IV analgesics (odds ratio: 0.330; 95% CI: 0.153-0.712; P = 0.005). After case-control matching, NRS immediately postoperatively ( P = 0.015) and 24 hours postsurgery ( P = 0.043), patients using additional IV analgesics ( P = 0.019), postoperative hospital stay ( P = 0.010), intraoperative blood loss ( P < 0.001), and postoperative complication rate ( P = 0.028) were significantly lower in the 3 mm group compared with the 5 mm group | ||
| 520 | |a CONCLUSIONS: The use of 3 mm trocars and instruments in laparoscopic colon cancer surgery can effectively reduce postoperative pain while maintaining perioperative safety | ||
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Analgesics |2 NLM | |
| 700 | 1 | |a Kim, Hyo Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Lim, Han-Ki |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Min Jung |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Rumi |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Ji Won |e verfasserin |4 aut | |
| 700 | 1 | |a Ryoo, Seung-Bum |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Kyu Joo |e verfasserin |4 aut | |
| 700 | 1 | |a Park, Hyeree |e verfasserin |4 aut | |
| 700 | 1 | |a Shin, Aesun |e verfasserin |4 aut | |
| 700 | 1 | |a Jeong, Seung-Yong |e verfasserin |4 aut | |
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