Ann Coloproctol.
2025 Apr;41(2):154-161. 10.3393/ac.2024.00563.0080.
Impact of single-port laparoscopic approach on scar assessment by patients and observers: a multicenter retrospective study
- Affiliations
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- 1Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
- 2Department of Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
- 3Division of Colorectal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 4Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University College of Medicine, Seoul, Korea
- 5Department of Surgery, Pyeongtaek St. Mary’s Hospital, Pyeongtaek, Korea
- KMID: 2567451
- DOI: http://doi.org/10.3393/ac.2024.00563.0080
Abstract
- Purpose
This study aimed to compare the wound cosmesis of a single-incision approach on scar assessment after laparoscopic surgery for colon cancer.
Methods
This study included 32 patients undergoing single-port laparoscopic surgery (SPLS) and 61 patients undergoing multiport laparoscopic surgery (MPLS) for colon cancer at 3 tertiary referral hospitals between September 2011 and December 2019. We modified and applied the Korean version of the Patient and Observer Scar Assessment Scale (POSAS) to assess cosmetic outcomes. To assess the interobserver reliability using intraclass correlation coefficient values for the Observer Scar Assessment Scale (OSAS), the surgeons evaluated 5 images of postoperative scars.
Results
No significant differences were observed in the time before the return of normal bowel function, time to sips of water and soft diet initiation, length of in-hospital stay, and postoperative complication rate. The SPLS group had a shorter total incision length than the MPLS group. The POSAS favored the SPLS approach, revealing significant differences in the Patient Scar Assessment Scale (PSAS), OSAS, and overall scores. The SPLS approach was an independent factor influencing the POSAS, PSAS, and OSAS scores. Eleven colorectal surgeons had a significantly substantial intraclass coefficient.
Conclusion
The cosmetic outcomes of SPLS as assessed by the patients and surgeons were superior to those of MPLS in colon cancer. Reducing the number of ports is an independent factor affecting scar assessment by patients and observers.
