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Comparative outcomes of single incision laparoscopy versus conventional laparoscopy in paediatric population: a meta
E Purnomo1,2, B S Pambudi3, A N Nabilah3
1Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito Hospital, Yogyakarta, Indonesia. eko.p@ugm.ac.id.
Introduction:
Single-incision laparoscopic surgery (SILS) and conventional laparoscopic surgery (CLS) are minimally invasive surgical techniques that are widely used as the treatment of appendicitis. While both techniques have demonstrated several advantages over laparotomy, such as reduced postoperative pain and faster recovery, SILS is hypothesized to further enhance clinical outcomes due to its less invasive approach. Hence, systematic comparisons of SILS and CLS are necessary to delineate the most efficient surgery for pediatric surgeons. This study aimed to compare postoperative outcomes between SILS and CLS in pediatric appendicitis, specifically focusing on complication rates, length of hospital stay (LOS), and duration of surgery.
Materials And Methods:
A comprehensive search of four databases (PubMed, ProQuest, Scopus, and ScienceDirect) was conducted in October 2024 to identify the eligible studies. Meta-analysis was performed using Comprehensive Meta-Analysis software, applying a random-effects model to calculate pooled effect sizes. Heterogeneity was evaluated using the I² and Q statistics to assess consistency across studies.
Results:
Six studies, encompassing a total of 838 children who underwent laparoscopic appendectomy, were included. The pooled analysis showed no statistically significant difference in complication rates between SILS and CLS (OR: 1.421, 95% Confidence Interval: 0.609-3.314, p=0.416), nor in length of hospital stay (SMD: -0.003, 95% Confidence Interval: -0.252-0.247, p=0.983).
Conclusion:
Both SILS and CLS demonstrate favorable outcomes for pediatric appendicitis surgery, with minimal differences in complication rates and recovery times. These findings suggest that both techniques were feasible choices, allowing for flexibility in choosing the surgical approach based on patient-specific factors and surgical expertise.
