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Suprapubic single-incision versus conventional laparoscopic appendectomy.

Ze Zhang¹, Yanan Wang¹, Ruoyan Liu¹

¹Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.

The Journal of Surgical Research

|August 18, 2015

Summary

Suprapubic single-incision laparoscopic appendectomy (SSILA) is safe and feasible, offering better cosmetic results than conventional laparoscopic appendectomy (CLA). SSILA showed comparable clinical outcomes but longer operative times and increased analgesic needs.

Keywords:

Appendicitis Propensity-matched analysis Suprapubic single-incision laparoscopic appendectomy

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Area of Science:

Minimally Invasive Surgery
Surgical Oncology
Gastrointestinal Surgery

Background:

Suprapubic single-incision laparoscopic appendectomy (SSILA) presents potential cosmetic advantages over conventional laparoscopic appendectomy (CLA).
Previous single-arm studies indicated SSILA's safety and feasibility.
This study employed a propensity-matched analysis to compare SSILA and CLA outcomes.

Purpose of the Study:

To compare the clinical and cosmetic outcomes of SSILA versus CLA.
To evaluate the safety and feasibility of SSILA in a matched cohort.

Main Methods:

Propensity score matching was used to compare patients undergoing SSILA and CLA.
Covariates included demographics, ASA score, prior surgery history, and appendix pathology.
Clinical outcomes and cosmetic results (patient scar assessment, objective scar scale) were assessed.

Main Results:

No conversions to open surgery or additional ports were needed in either group.
Wound infection and intra-abdominal abscess occurred in one patient each.
SSILA demonstrated superior scar consciousness scores but longer operative times and higher analgesic requirements compared to CLA.

Conclusions:

SSILA is a safe and feasible alternative to CLA with comparable clinical outcomes.
SSILA offers improved cosmetic results, specifically reduced scar consciousness.
The trade-offs for SSILA include longer operative times and increased postoperative analgesic use.