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World J Surg. 2014 Aug;38(8):1937-46. doi: 10.1007/s00268-014-2535-x.

Systematic review and meta-analysis of randomized controlled trials comparing single incision versus conventional laparoscopic appendectomy.

Author information

1
Department of Surgery, "La Mancha Centro" General Hospital, Avd. de la Constitución nº 3. 13600, Alcázar de San Juan, Ciudad Real, Spain, michaelclerveus@yahoo.fr.

Abstract

BACKGROUND:

Single incision laparoscopic appendectomy (SILA) has been proposed as an alternative to conventional laparoscopic appendectomy (CLA).

OBJECTIVE:

The aim of this study was to evaluate the safety and efficacy of SILA when compared with CLA through a systematic review.

METHODS:

We performed an electronic search of EMBASE, PubMed, MEDLINE, and Cochrane Central Register of Controlled Trials. Randomized controlled trials (RCTs) that compared SILA with CLA were included.

RESULTS:

Six RCTs met eligibility criteria, which included a total of 800 patients, 401 in the SILA group and 399 in the CLA group. There were no significant differences in terms of overall complications (odds ratio [OR] 0.93; 95% confidence interval [CI] 0.59-1.47; p = 0.77). SILA had a higher technical failure rate (OR 3.30; 95% CI 1.26-8.65; p = 0.01) and required a longer operative time (mean difference [MD] 4.67; 95% CI 1.76-7.57; p = 0.002). SILA was associated with better cosmetic results (standardized MD -0.4; 95% CI -0.64 to -0.16; p = 0.001) and earlier return to normal activity (MD -0.64; 95% CI -1.09 to -0.20; p = 0.005), although these advantages should be taken with caution due to the small number of studies reporting these two items and the short follow-up in the evaluation of cosmetic results. There were no significant differences in terms of postoperative pain or length of hospital stay between groups.

CONCLUSIONS:

SILA is comparable to CLA in selected patients, although it is associated with a higher technical failure rate and longer operative time. Further randomized trials are needed to determine if SILA really offers benefits over CLA.

PMID:
24682257
DOI:
10.1007/s00268-014-2535-x
[Indexed for MEDLINE]

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