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Single-incision laparoscopic appendectomy vs conventional laparoscopic appendectomy: systematic review and
Yu-Long Cai1, Xian-Ze Xiong, Si-Jia Wu
1Department of Bile Duct Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World Journal of Gastroenterology
|August 22, 2013
Summary
Single-incision laparoscopic appendectomy (SILA) offers better cosmetic results but has a longer operative time and higher conversion rate compared to conventional laparoscopic appendectomy (CLA). Further research is needed to fully evaluate clinical benefits and disadvantages.
Area of Science:
- Minimally Invasive Surgery
- Surgical Outcomes Research
- Gastrointestinal Surgery
Background:
- Appendectomy is a common surgical procedure.
- Laparoscopic appendectomy techniques are evolving.
- Single-incision laparoscopic appendectomy (SILA) aims to reduce invasiveness and improve cosmesis compared to conventional laparoscopic appendectomy (CLA).
Purpose of the Study:
- To compare the clinical benefits and disadvantages of SILA versus CLA.
- To evaluate operative time, conversion rates, complications, and cosmetic outcomes.
- To synthesize evidence from randomized controlled trials (RCTs).
Main Methods:
- A systematic literature search was conducted across multiple databases (Cochrane Library, MEDLINE, Embase, etc.) up to January 2013.
- Included randomized controlled trials (RCTs) comparing SILA and CLA.
- Meta-analysis of data from 1068 patients was performed using Review Manager 5.2.0.
Main Results:
- Six RCTs (535 SILA, 533 CLA) were analyzed; five had a high risk of bias.
- SILA showed significantly longer operative time (MD = 5.68 min) and higher conversion rates (RR = 5.14) than CLA.
- SILA resulted in better cosmetic satisfaction scores (MD = 0.52), with no significant differences in total complications, drain insertion, or hospital stay.
Conclusions:
- The primary benefit of SILA is improved cosmetic satisfaction.
- Disadvantages of SILA include increased operative time and a higher likelihood of conversion to CLA.
- Further research is warranted due to the risk of bias in existing studies and limited data on postoperative pain.
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