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Needlescopic versus laparoscopic appendectomy: a systematic review.

Muhammad Shafique Sajid1, Munir Ahmad Khan, Elizabeth Cheek

  • 1Department of Colorectal Surgery, Worthing Hospital, Worthing, West Sussex, UK. surgeon1wrh@hotmail.com

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|April 29, 2009
PubMed
Summary
This summary is machine-generated.

Needlescopic appendectomy (NA) is safe and effective for appendicitis, comparable to laparoscopic appendectomy (LA) in hospital stay and complications. However, NA takes longer and has a higher conversion rate, requiring further study.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Outcomes Research
  • Gastrointestinal Surgery

Background:

  • Needlescopic appendectomy (NA), a minimally invasive technique, has been utilized since the 1990s.
  • Appendicitis management often involves surgical intervention, with laparoscopic appendectomy (LA) being a common approach.

Purpose of the Study:

  • To systematically analyze and compare the outcomes of needlescopic appendectomy (NA) versus laparoscopic appendectomy (LA).
  • To evaluate the safety and efficacy of NA in the management of appendicitis.

Main Methods:

  • A systematic review of published literature was conducted.
  • Clinical trials comparing NA and LA were analyzed using fixed- and random-effects models.
  • Standardized mean differences (SMD) were calculated to compare outcomes.

Main Results:

  • Two trials involving 412 patients met the inclusion criteria.
  • Needlescopic appendectomy demonstrated a statistically significant longer operative time (SMD 0.20 min, p = 0.030).
  • No significant differences were found in hospital stay or perioperative complications between NA and LA. NA showed a higher conversion rate to open surgery.

Conclusions:

  • Needlescopic appendectomy is a safe and effective alternative to laparoscopic appendectomy for appendicitis.
  • While comparable in hospital stay and complications, NA presents challenges with longer operative times and increased conversion rates.
  • Further large-scale multicenter randomized controlled trials are recommended before routine adoption of NA.