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Single-incision compared with conventional laparoscopy for appendectomy in acute appendicitis: a systematic review and meta-analysis

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Abstract

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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Authors and Affiliations

  1. Department 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

    Changjia Li & Zhiwei Wang

  2. Department of Breast Surgery III, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, 266042, Qingdao, Shandong, China

    Yukun Liu

  3. Department of Internal Medicine-Neurology I, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, Shandong, Qingdao, 266042, China

    Yumin Jiang

  4. Department of Abdominal Oncology Surgery, The Affiliated Qingdao Central Hospital of Qingdao University, The Second Affiliated Hospital of Medical College of Qingdao University, 266042, Qingdao, Shandong, China

    Yongjing Xu

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  1. Changjia Li
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Contributions

CL and YL searched the literature, respectively, discussed with YJ where there were differences. YX performed the statistical analysis. The manuscript was drafted by CL and YL. All authors approved the final version, and ZW had final responsibility for the decision to submit for publication.

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Correspondence to Zhiwei Wang.

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Li, C., Liu, Y., Jiang, Y. et al. Single-incision compared with conventional laparoscopy for appendectomy in acute appendicitis: a systematic review and meta-analysis. Int J Colorectal Dis 37, 1925–1935 (2022). https://doi.org/10.1007/s00384-022-04231-6

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