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Single-incision compared with conventional laparoscopy for appendectomy in acute appendicitis: a systematic review
Changjia Li1, Yukun Liu2, Yumin Jiang3
1Department of Colorectal and Anal Surgery, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, 266042, Qingdao, Shandong, China.
Objective:
A meta-analysis of the relevant literature evaluated the feasibility, safety, and potential benefits of single-incision laparoscopic appendectomy (SILA) relative to those of conventional laparoscopic appendectomy (CLA).
Methods:
The major biomedical databases, including ClinicalTrials.gov, were searched up to January 2022 for relevant randomized controlled trials (RCTs). SILA and CLA were compared regarding patient body mass index, operative time, and perioperative complications. The Cochrane Handbook and RevMan 5.3 were used to judge trial quality and perform the meta-analysis, respectively.
Results:
The 17 included RCTs comprised 2068 patients, of whom 1039 and 1029 patients underwent SILA and CLA, respectively. The operative time for SILA was longer than that for CLA (MD = 8.35 min, 95% CI = 6.58 to 10.11, P < 0.00001), but the cosmetic results from SILA were superior (SMD = 0.81, 95% CI = 0.58 to 1.03, P < 0.00001). However, the incidence rates were similar in terms of patient body mass index; postoperative pain scores; and rates of abdominal abscess, conversion to open surgery, ileus, surgical site infection, and overall perioperative complications between the two groups.
Conclusion:
SILA is a safe technique for acute appendicitis, and its cosmetic outcomes are superior to those of CLA.
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