Safety and efficacy of single-incision laparoscopic surgery for appendectomies: a meta-analysis

To compare single incision laparoscopic surgery for an appendectomy (SILS-A) with conventional laparoscopic appendectomy (C-LA) when implemented by experienced surgeons.

Studies and relevant literature regarding the performance of single-incision laparoscopic surgery vs conventional laparoscopic surgery for appendectomy were searched for in the Cochrane Central Register of Controlled Clinical Trials, MEDLINE, EMBASE and World Health Organization international trial register. The operation time (OR time), complications, wound infection and postoperative day using SILS-A or C-LA were pooled and compared using a meta-analysis. The risk ratios and mean differences were calculated with 95%CIs to evaluate the effect of SILS-A.

Sixteen recent studies including 1624 patients were included in this meta-analysis. These studies demonstrated that, compared with C-LA, SILS-A has a similar OR time in adults but needs a longer OR time in children. SILS-A has similar complications, wound infection and length of the postoperative day in adults and children, and required similar doses of narcotics in children, the pooled mean different of -0.14 [95%CI: -2.73-(-2.45), P > 0.05], the pooled mean different of 11.47 (95%CI: 10.84-12.09, P < 0.001), a pooled RR of 1.15 (95%CI: 0.72-1.83, P > 0.05), a pooled RR of 1.9 (95%CI: 0.92-3.91, P > 0.05), a pooled RR of 1.01 (95%CI: 0.51-2.0, P > 0.05) a pooled RR of 1.86 (95%CI: 0.77-4.48, P > 0.05), the pooled mean different of -0.25 (95%CI: -0.50-0, P = 0.05) the pooled mean different of -0.01 (95%CI: -0.05-0.04, P > 0.05) the pooled mean different of -0.13 (95%CI: -0.49-0.23, P > 0.05) respectively.

SILS-A is a technically feasible and reliable approach with short-term results similar to those obtained with the C-LA procedure.