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Single incision versus conventional multiport laparoscopic appendectomy: a systematic review and meta-analysis of
Haiyang Zhou1, Kaizhou Jin, Jian Zhang
1Department of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, PR China.
Background:
The efficacy of single incision laparoscopic appendectomy (SILA) in comparison with conventional multiport laparoscopic appendectomy (CMLA) has not been conclusively determined.
Methods:
A systematic literature review (Medline, EMBASE, Science Citation Index, and Cochrane Central Register of Controlled Trials) was performed. Meta-analyses of randomized controlled trials (RCTs) comparing SILA with CMLA were carried out by RevMan 5.0 software.
Results:
Eleven RCTs comparing SILA and CMLA were included. Overall, 1,216 patients were operated on: 611 cases by SILA versus 605 cases by CMLA. Compared with CMLA, SILA was associated with increased procedural difficulty, prolonged procedural duration, shorter length of hospital stay, earlier return to normal activity and better cosmesis. There were no significant differences in postoperative pain scores and complication rates between SILA and CMLA.
Conclusion:
The current best evidence shows SILA holds the promise of improving postoperative recovery and cosmetic result with equal efficacy and safety, whereas it is associated with higher surgical difficulty with longer surgical time when compared with CMLA.
Insights
Single incision laparoscopic appendectomy (SILA) offers better cosmetic results and faster recovery than conventional multiport laparoscopic appendectomy (CMLA). However, SILA presents increased surgical difficulty and longer operative times, with comparable safety and efficacy.
Area of Science:
- Minimally Invasive Surgery
- Surgical Techniques
- Gastrointestinal Surgery
Background:
- The comparative effectiveness of single incision laparoscopic appendectomy (SILA) versus conventional multiport laparoscopic appendectomy (CMLA) remains unclear.
- Appendectomy is a common surgical procedure for appendicitis.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials (RCTs) comparing SILA and CMLA.
- To determine the safety, efficacy, and patient outcomes of SILA relative to CMLA.
Main Methods:
- Systematic literature search of Medline, EMBASE, Science Citation Index, and Cochrane Central Register of Controlled Trials.
- Meta-analysis of 11 RCTs involving 1,216 patients (611 SILA, 605 CMLA) using RevMan 5.0 software.
Main Results:
- SILA demonstrated a shorter hospital stay, earlier return to normal activities, and improved cosmetic outcomes compared to CMLA.
- Procedural difficulty and duration were higher in SILA.
- No significant differences were observed in postoperative pain or complication rates between the two techniques.
Conclusions:
- SILA shows potential for enhanced postoperative recovery and cosmesis with comparable safety and efficacy to CMLA.
- Increased surgical difficulty and operative time are associated with SILA.
