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Quality of life and patient satisfaction after single- and multiport laparoscopic surgery in colon cancer: a multicentre randomised controlled trial (SIMPLE Trial)

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Abstract

Background

The clinical benefits of single-port laparoscopic surgery (SPLS) in patients with colon cancer patients are unclear because only a few studies have reported on the quality of life (QoL) of such patients. This study aimed to compare the QoL and patient satisfaction between SPLS and multiport laparoscopic surgery (MPLS) in colon cancer.

Methods

The multicentre randomised controlled SIngle-port versus MultiPort Laparoscopic surgEry (SIMPLE) trial included patients with colon cancer who underwent radical surgery at seven hospitals in South Korea. We performed a pre-planned secondary analysis of the QoL data of 359 patients from that trial. The QoL was surveyed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 preoperatively and at 1, 3, 6, and 12 months postoperatively. Patient satisfaction was measured with a 5-point questionnaire at these postoperative time points.

Results

Overall, 145 and 147 patients were included in the SPLS and MPLS groups, respectively. Most QoL domains were similar between the groups. In the subgroup analysis of patients without adjuvant chemotherapy, patients in the SPLS group presented with significantly better global health status (p = 0.017), fatigue (p = 0.047), and pain (p = 0.005) scores and tended to have improved physical (p = 0.055), emotional (p = 0.064), and social (p = 0.081) functioning, with marginal significance at 1 month postoperatively, compared to those in the MPLS group. Patient satisfaction regarding surgery (p = 0.002) and appearance of the abdominal scar (p = 0.002) was significantly higher with SPLS than with MPLS at 12 months postoperatively.

Conclusion

Patients who underwent SPLS without adjuvant chemotherapy had better global health status, fatigue status, and pain at 1 month postoperatively; however, these improvements were minimal and temporary. In the near future, the effect of SPLS on postoperative QoL should be confirmed through a randomised controlled trial targeting the QoL in colon cancer patients.

Trial registration

ClinicalTrials.gov Identifier: NCT01480128

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Funding

This study was funded by a Korean Society of Endoscopic and Laparoscopic Surgeons research grant (D2011-49).

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Authors and Affiliations

  1. Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea

    Byung Mo Kang

  2. Department of Surgery, Seoul St. Mary’s Hospital College of Medicine, The Catholic University Hospital, Seoul, Korea

    Yoon Suk Lee & Jun Gi Kim

  3. Department of Surgery, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University Hospital, Incheon, Korea

    Ji Hoon Kim

  4. Department of Surgery, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University Hospital, Seoul, Korea

    Hyung Jin Kim

  5. Department of Surgery, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University Hospital, Daejeon, Korea

    Sang Chul Lee

  6. Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, Korea

    Chang Woo Kim & Suk-Hwan Lee

  7. Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea

    Sang Woo Lim

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  1. Byung Mo Kang
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Kang, B.M., Lee, Y.S., Kim, J.H. et al. Quality of life and patient satisfaction after single- and multiport laparoscopic surgery in colon cancer: a multicentre randomised controlled trial (SIMPLE Trial). Surg Endosc 35, 6278–6290 (2021). https://doi.org/10.1007/s00464-020-08128-9

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