Reduced-Port Versus Multi-Port Laparoscopic Colectomy for Colorectal Cancer: A Systematic Review, Meta-Analysis, and Meta-Regression
In brief
Reduced-port colectomy cuts operating time by about 20 minutes, with similar outcomes
Across 13 studies involving 2,897 patients, reduced-port surgery took about 20 minutes less and lost about 14 mL less blood than multi-port surgery, with no clear differences in hospital stay, lymph node counts or complications. Most evidence was retrospective and varied across studies, so the results support feasibility, not superiority; tumor stage also influenced operating time.
- Journal
- Annals of gastroenterological surgery (Q1)
- Published
- 18 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Ayesha Shaukat, Saad Ashraf, Hamza Irfan, Muhammad Shahmeer Ullah Shah, Yumna Khabir, Santosh Sah, et al.
- PMID
- 42984820
- DOI
- 10.1002/ags3.70264
Why clinicians should know about it
- Picked for Surgical Oncology (top studies of the week, 8 November 2026): Reduced-port colectomy comparable outcomes to multi-port
Abstract
BACKGROUND: Reduced-port laparoscopic colectomy (RPLC) has emerged as an alternative to multi-port laparoscopic colectomy (MPLC) for colorectal cancer surgery, aiming to reduce operative morbidity and improve cosmetic outcomes. This systematic review and meta-analysis evaluated and compared operative, postoperative, and oncologic outcomes between RPLC and MPLC. METHODS: Following PRISMA guidelines, we systematically searched PubMed, Cochrane Library, ScienceDirect, and Google Scholar from inception to June 2025. The protocol was registered on PROSPERO (CRD420251078328). Included studies were randomized controlled trials (RCTs) or cohort studies comparing RPLC and MPLC. Primary outcomes were estimated blood loss, operative time, hospital stay, lymph node yield, and postoperative recovery indicators. Secondary outcomes included conversion rates, complications, and Clavien-Dindo graded adverse events. Risk of bias was evaluated using the Newcastle-Ottawa Scale and Cochrane RoB 2.0 tool. A random-effects meta-regression was performed to explore the impact of high-stage tumors on the outcomes. RESULTS: Thirteen studies (n = 2897) were included. RPLC significantly reduced operative time (MD: -19.98 min; 95% CI: -29.73 to -10.24, p < 0.0001) and estimated blood loss (MD: -13.70 mL; 95% CI: -25.63 to -1.77, p = 0.02) without compromising hospital stay, lymph node yield, or complication rates. Meta-regression revealed tumor stage significantly influenced operative time (p = 0.0013). CONCLUSIONS: RPLC appears to provide comparable postoperative outcomes to MPLC with modest intraoperative advantages. As the evidence is largely retrospective and heterogeneous, these findings indicate the feasibility of RPLC rather than its superiority over MPLC. High-quality clinical trials with longer follow-up are required to confirm these findings and optimize clinical decision-making. TRIAL REGISTRATION: PROSPERO registration ID: CRD420251078328.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.