To compare the clinical efficacy of three-port reduced-port laparoscopic surgery with conventional five-port laparoscopic surgery for radical resection of colorectal cancer, and to evaluate the safety, effectiveness, and clinical value of the three-port approach.

A retrospective analysis was conducted on the clinicopathological data of 84 patients who underwent laparoscopic radical resection for colorectal cancer at our institution between Jan. 2024 and Mar. 2025. According to the port configuration used during surgery, patients were divided into a three-port group (reduced-port group, n=26) and a five-port group (conventional group, n=58). Baseline characteristics, intraoperative parameters, oncological outcomes, postoperative recovery, and complication rates were compared between the two groups.

No significant differences were observed in baseline characteristics, including sex, age, BMI, NRS 2002 score, history of prior abdominal surgery, preoperative hemoglobin levels, or tumor location (all P>0.05), indicating good baseline comparability. The total abdominal incision length was significantly shorter in the three-port group(5.2±1.2 cm) compared to the five-port group(7.8±0.8 cm) (P<0.001). The time to first postoperative flatus was significantly earlier in the three-port group compared with the five-port group (48.5 ± 8.2 h vs. 56.8±10.5 h; P<0.001). There were no statistically significant differences in operative time, intraoperative blood loss, tumor size, pathological T stage, or number of harvested lymph nodes (all P>0.05). The overall postoperative complication rate was comparable between the two groups (P>0.05).

The three-port reduced-port laparoscopic approach for radical resection of colorectal cancer achieves comparable oncological outcomes and safety to the conventional five-port method. It offers distinct advantages in terms of shorter incision length and faster recovery of gastrointestinal function, without increasing operative time, blood loss, or complication risk. This technique is safe, effective, and minimally invasive, and represents a promising surgical option worthy of broader clinical adoption in high-volume centers with established laparoscopic expertise.