Single plus one-port robotic surgery using the da Vinci Single-Site Platform versus conventional multi-port laparoscopic surgery for left-sided colon cancer

Introduction
Recently, single plus one-port robotic surgery (SPORS) was introduced to overcome the limitations of single-port laparoscopic surgery for the treatment of various diseases. Aim: To compare the clinical and cosmetic outcomes of SPORS with those of multi-port laparoscopic surgery (MPLS), which is presently the standard surgical treatment for colon cancer.

Material and methods
The study included 36 patients who underwent SPORS and 61 patients who underwent MPLS for left-sided colon cancer between August 2014 and January 2016. The Patient Scar Assessment Questionnaire (PSAQ) was used to assess cosmetic outcomes.

Results
SPORS involved a longer median operative time than MPLS (232 vs. 155 min, p = 0.009). There were no apparent differences in the time before diet tolerance, length of hospital stay, postoperative pain score, and postoperative complication rate. However, SPORS patients had a shorter total incision length (5.0 vs. 8.0 cm, p < 0.001). The median proximal and distal resection margins and the median number of harvested lymph nodes were comparable between the two groups. The PSAQ favored the SPORS approach, revealing significant differences in appearance (15 vs. 18, p < 0.001), consciousness (9 vs. 11, p < 0.001), satisfaction with appearance (14 vs. 17, p < 0.001), satisfaction with symptoms (9 vs. 10, p = 0.022), and overall score (47 vs. 55, p < 0.001).

Conclusions
The clinicopathologic outcomes of SPORS were comparable but its cosmetic outcomes were superior to those of MPLS for left-sided colon cancer.