Format

Send to

Choose Destination
See comment in PubMed Commons below
Am J Surg. 2014 Apr;207(4):613-22. doi: 10.1016/j.amjsurg.2013.07.045. Epub 2013 Nov 9.

Meta-analysis of randomized trials on single-incision laparoscopic versus conventional laparoscopic appendectomy.

Author information

  • 1Center for Minimally Invasive Surgery, Neuwerk Hospital, Mönchengladbach, Germany; Department of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece. Electronic address: stavros.antoniou@hotmail.com.
  • 2Department of General and Visceral Surgery, Hospital of Linz, Linz, Austria.
  • 3Department of Vascular Surgery, Hellenic Red Cross Hospital, Athens, Greece.
  • 4Department of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
  • 5Department of General and Visceral Surgery, Hospital Zell am See, Zell am See, Austria.
  • 6Center for Minimally Invasive Surgery, Neuwerk Hospital, Mönchengladbach, Germany.

Abstract

BACKGROUND:

Single-incision laparoscopic appendectomy has emerged as a less invasive alternative to conventional laparoscopic surgery. High-quality relevant evidence is limited.

METHODS:

A systematic review of electronic information sources was undertaken, with the objective of identifying randomized trials that compared single-incision with conventional laparoscopic appendectomy. Outcome measures included 30-day morbidity, abdominal abscess, wound infection, open conversion, reoperation, operative time, length of hospital stay, and postoperative pain. Fixed-effects and random-effects models were used to calculate combined overall effect sizes of pooled data. Data are presented as odds ratios or weighted mean differences with 95% confidence intervals (CIs).

RESULTS:

Five randomized trials were identified, with a total of 746 patients. Thirty-day morbidity (9.6% vs 8.6%; odds ratio, 1.14; 95% CI, .69 to 1.89) and wound infection rates were similar between single-incision and conventional laparoscopy (4.0% vs 4.8%; odds ratio, .83; 95% CI, .41 to 1.68), whereas the duration of surgery was longer in the single-incision group (46.3 vs 40.7 minutes; weighted mean difference, 6.01; 95% CI, 2.26 to 9.76). Available data were not adequately robust to reach conclusions regarding the remaining outcome measures.

CONCLUSIONS:

Similar postoperative morbidity and wound infection rates for single-incision and conventional laparoscopic appendectomy are supported by the current literature, but single-incision surgery requires longer operative time.

Copyright © 2014 Elsevier Inc. All rights reserved.

KEYWORDS:

Appendectomy; Laparoscopy; SILS; Single-access; Single-incision; Single-port

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk