The excitement to develop new techniques has given rise to natural orifice transluminal endoscopic surgery (NOTES) [8�C10]. This procedure in both animal [11] and human [12] models has shown some success but scientific assay certainly has technical challenges: using transgastric, transvaginal, and transrectal access to the abdominal viscera and the need for expensive specialized equipment has hindered the widespread acceptance of this approach. Therefore use of the NOTES approach in performing routine colon resection is far from being practical at this time. Single-incision laparoscopic surgery (SILS) has advantages over NOTES in that existing laparoscopic instruments can be used and relatively minor adjustments from the current multiport laparoscopic technique are needed.
The initial applications of SILS in gastrointestinal surgery were cholecystectomy [13], appendectomy [14] and recently, this technique has also been applied to colorectal surgery [15�C18]. In comparison to multiport laparoscopic colectomy, the potential advantages of SILS are thought to be improved cosmesis as well as incisional and/or parietal pain and avoidance of port site-related complications [40]. Since 2008 when single-incision laparoscopic colectomy (SILC) was first introduced, the number of relevant publications has been increasing year by year as shown in Figure 1. However, because of still limited number of studies reporting SILC [41], its clinical significance remains to be elucidated. The aim of this study is to analyze current literature on SILC and access its potential benefits or efficacy as well as its feasibility and safety.
Figure 1 The number of publications regarding single-incision laparoscopic colectomy. 2. Materials and Methods 2.1. Literature Search Strategies A systematic search of the scientific literature was carried out using the MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials ClinicalTrials.gov (Available at: http://clinicaltrials.gov/), National Research Register, The York (UK) Centre for Reviews, American College of Physicians (ACP) Journal Club, Australian Clinical Trials Registry, relevant online journals, and the Internet for the years 1983�CAugust 2011 to obtain access to all relevant publications, especially randomized controlled trials, systematic reviews, and meta-analyses involving SILC.
The search terms were ��single-incision,�� ��single port,�� ��single access,�� ��single site,�� ��laparoscopic colectomy,�� ��colectomy,�� and ��laparoscopic colorectal surgery.�� 2.2. Inclusion and Exclusion Criteria Articles were selected if the abstract contained data on patients who underwent SILC for colorectal diseases in the form of RCTs Entinostat and other controlled or comparative studies. Conference abstracts were included if they contained relevant data. The reference lists of these articles were also reviewed to find additional candidate studies. Searches were conducted without language restriction.