Abstract
Background
There is no consensus that single-incision laparoscopic appendectomy (SILS-A) is on
a par with conventional multiport laparoscopic appendectomy (CMLA). The aim of this
meta-analysis was to assess feasibility, safety, and potential benefits of SILS-A
when compared with CMLA.
Methods
A literature search for studies comparing SILS-A and CMLA was performed. Studies were
reviewed for the outcome of interest: patient characteristics, operative outcome,
postoperative recovery, postoperative morbidity, patient satisfaction, and cosmetic
results.
Results
Thirteen studies comparing SILS-A and CMLA were reviewed: two prospective randomized
trials, four prospective studies, and seven retrospective studies. Overall, 893 patients
were operated on: by SILS-A in 402 cases (45.0%) versus 491 cases (55.0%) by CMLA. Patients in the SILS-A group were significantly younger
than those in the CMLA group (31.2 versus 33.5 y). No other differences were found. Patient satisfaction score was impossible
to meta-analyze.
Conclusions
Appendectomy via SILS-A may be considered as an alternative to CMLA. However, these results must be
approached with caution as they are based on data from nonrandomized observational
studies. The feasibility and safety of SILS-A must be mainly assessed for difficult
clinical situations such as severe obesity, localized abscess, or diffuse peritonitis
from a ruptured appendix in the setting of new prospective randomized trials.
Keywords
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References
- Laparoscopic versus open appendectomy for acute appendicitis: a meta-analysis.Surg Endosc. 2011; 25: 1199
- Comparison of outcomes of laparoscopic and open appendectomy in management of uncomplicated and complicated appendicitis.Ann Surg. 2011; 254: 927
- Long-term follow-up of a randomized clinical trial of open versus laparoscopic appendicectomy.Br J Surg. 2010; 97: 1395
- Single-incision versus conventional three-incision laparoscopic appendectomy: a single center experience.Surg Today. 2012; 45: 542
- Pain after laparoscopic appendectomy: a comparison of transumbilical single-port and conventional laparoscopic surgery.J Korean Surg Soc. 2012; 82: 172
- Single-port laparoscopic appendectomy: comparison with conventional laparoscopic appendectomy.J Laparoendosc Adv Surg Tech. 2012; 22: 142
- Single-port transumbilical laparoscopic appendectomy: a preliminary multicentric comparative study in 87 patients with acute appendicitis.Minim Invasive Surg. 2012; 2012: 492409
- Single-site versus conventional laparoscopic appendectomy: comparison of short-term operative outcomes.Surg Endosc. 2011; 25: 36
- Initial experience in laparoscopic single-port appendectomy: a pilot study.Dig Surg. 2011; 28: 74
- A case-controlled comparison of single-site access versus conventional three-port laparoscopic appendectomy.Surg Endosc. 2011; 25: 1415
- Single incision laparoscopic surgery for appendicectomy: a retrospective comparative analysis.Surg Endosc. 2010; 24: 2567
- Application of single incision laparoscopic surgery for appendectomies in patients with complicated appendicitis.J Korean Soc Coloproctol. 2010; 26: 388
- Laparoscopic transumbilical single-port appendectomy: initial experience and comparison with three-port appendectomy.Surg Laparosc Endosc Percutan Tech. 2010; 20: 100
- Laparoscopic vs. transumbilical single-port laparoscopic appendectomy: results of prospective randomized trial.J Korean Surg Soc. 2010; 78: 213
- Laparoendoscopic single-site surgery appendectomy.Surg Endosc. 2010; 24: 686
- Comparative study on surgical outcomes and operative costs of transumbilical single-port laparoscopic appendectomy in adult patients.Surg Laparosc Endosc Percutan Tech. 2009; 19: 493
- Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of Observational Studies in Epidemiology (MOOSE) group.JAMA. 2000; 283: 2008
- A review of minimally invasive single-port/incision laparoscopic appendectomy.J Laparoendosc Adv Surg Tech A. 2012; 22: 641
- Single-incision appendectomy is comparable to conventional laparoscopic appendectomy: a systematic review and pooled analysis.Surg Laparosc Endosc Percutan Tech. 2012; 22: 319
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration.BMJ. 2009; 339: b2700
- Meta-analysis of prospective randomized studies comparing single-incision laparoscopic cholecystectomy (SILC) and conventional multiport laparoscopic cholecystectomy (CMLC).J Gastrointest Surg. 2012; 16: 1790
- Meta-analysis in clinical trials.Control Clin Trials. 1986; 7: 177
http://www.medcalc.org/manual/meta-continuous.php; 2013 [accessed 08.04.13].
http://www.medcalc.org/manual/meta-oddsratio.php; 2013 [accessed 08.04.13].
- Laparoscopic appendectomy is superior to open appendectomy in obese patients.Am J Surg. 2007; 194: 877
- Transumbilical single-port surgery: evolution and current status.Eur Urol. 2008; 54: 1020
- Laparoscopic versus open appendectomy in complicated appendicitis: a review of the NSQIP database.J Surg Res. 2010; 163: 225
Article info
Publication history
Published online: April 04, 2013
Accepted:
March 13,
2013
Received in revised form:
February 14,
2013
Received:
November 11,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
