Pain after single-incision versus conventional laparoscopic appendectomy: a propensity-matched analysis

Area of Science:

• Surgical Innovation
• Pain Management
• Minimally Invasive Surgery

Background:

• Acute appendicitis is a common surgical emergency.
• Laparoscopic appendectomy is the standard surgical approach.
• Single-incision laparoscopic appendectomy (SILA) is an alternative technique aiming to reduce surgical trauma.

Purpose of the Study:

• To compare postoperative pain outcomes between SILA and conventional laparoscopic appendectomy (CLA).
• To evaluate secondary outcomes including nausea, vomiting, and analgesic requirements.
• To assess the impact of surgical approach on patient recovery using propensity score matching.

Main Methods:

• Retrospective analysis of adult patients with acute appendicitis from January 2010 to December 2015.
• Comparison of SILA and CLA groups using 1:1 propensity score matching.
• Intravenous patient-controlled analgesia (PCA) used for all patients postoperatively.

Main Results:

• After propensity score matching, 111 patients were in each group (SILA vs. CLA).
• The SILA group showed significantly lower pain scores on the day of surgery (P=0.007).
• Rescue analgesic use was also significantly lower in the SILA group (P=0.043).

Conclusions:

• Single-incision laparoscopic appendectomy (SILA) demonstrates superior postoperative pain control compared to CLA.
• SILA may offer enhanced recovery and improved patient comfort.
• This suggests SILA is a beneficial surgical option for managing appendicitis.