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Open Access 08-02-2024 | Appendectomy | Review Article

Laparoscopic appendectomy with single port vs conventional access: systematic review and meta-analysis of randomized clinical trials

Authors: Roberto Cirocchi, Maria Chiara Cianci, Lavinia Amato, Luca Properzi, Massimo Buononato, Vanessa Manganelli Di Rienzo, Giovanni Domenico Tebala, Stefano Avenia, Ruggero Iandoli, Alberto Santoro, Nereo Vettoretto, Riccardo Coletta, Antonino Morabito

Published in: Surgical Endoscopy | Issue 4/2024

Abstract

Background

Conventional three-access laparoscopic appendectomy (CLA) is currently the gold standard treatment, however, Single-Port Laparoscopic Appendectomy (SILA) has been proposed as an alternative. The aim of this systematic review/meta-analysis was to evaluate safety and efficacy of SILA compared with conventional approach.

Methods

Per PRISMA guidelines, we systematically reviewed randomised controlled trials (RCTs) comparing CLA vs SILA for acute appendicitis. The randomised Mantel–Haenszel method was used for the meta-analysis. Statistical data analysis was performed with the Review Manager software and the risk of bias was assessed with the Cochrane "Risk of Bias" assessment tool.

Results

Twenty-one studies (RCTs) were selected (2646 patients). The operative time was significantly longer in the SILA group (MD = 7,32), confirmed in both paediatric (MD = 9,80), (Q = 1,47) and adult subgroups (MD = 5,92), (Q = 55,85). Overall postoperative morbidity was higher in patients who underwent SILA, but the result was not statistically significant. In SILA group were assessed shorter hospital stays, fewer wound infections and higher conversion rate, but the results were not statistically significant. Meta-analysis was not performed about cosmetics of skin scars and postoperative pain because different scales were used in each study.

Conclusions

This analysis show that SILA, although associated with fewer postoperative wound infection, has a significantly longer operative time. Furthermore, the risk of postoperative general complications is still present. Further studies will be required to analyse outcomes related to postoperative pain and the cosmetics of the surgical scar.

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Title: Laparoscopic appendectomy with single port vs conventional access: systematic review and meta-analysis of randomized clinical trials
Authors: Roberto Cirocchi
Maria Chiara Cianci
Lavinia Amato
Luca Properzi
Massimo Buononato
Vanessa Manganelli Di Rienzo
Giovanni Domenico Tebala
Stefano Avenia
Ruggero Iandoli
Alberto Santoro
Nereo Vettoretto
Riccardo Coletta
Antonino Morabito
Publication date: 08-02-2024
Publisher: Springer US
Keywords: Appendectomy
Appendicitis
Appendicitis
Published in: Surgical Endoscopy / Issue 4/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10659-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic appendectomy with single port vs conventional access: systematic review and meta-analysis of randomized clinical trials

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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