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World Journal of Surgery
Published in: World Journal of Surgery 11/2012

01-11-2012

Single-Incision Laparoscopic Cholecystectomy Versus Conventional Laparoscopic Cholecystectomy: Meta-analysis and Systematic Review of Randomized Controlled Trials

Authors: Muhammad S. Sajid, Nikhil Ladwa, Lorain Kalra, Kristian K. Hutson, Krishna K. Singh, Mazin Sayegh

Published in: World Journal of Surgery | Issue 11/2012

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Abstract

Background

The objective of this study was to analyze systematically the randomized, controlled trials that compared single-incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC).

Methods

The meta-analysis was conducted according to the Quality of Reporting of Meta-analysis (QUORUM) standards. The included studies were analyzed systematically using the statistical software package RevMan. The summated outcomes were expressed as the risk ratios (RR) for dichotomous variables and standardized mean differences (SMD) for continuous variables.

Results

Eleven randomized trials encompassing 858 patients were retrieved from the electronic databases. In the random effects model, postoperative pain, postoperative complications, length of hospital stay, cosmesis score, conversion rate, and time to return to normal activities were statistically comparable between the two cholecystectomy techniques. SILC was associated with a longer operating time [SMD 0.71; 95 % confidence interval (CI) 0.38, 1.05; z = 4.18; p < 0.0001) and an increased requirement for additional port insertion (RR 6.54; 95 % CI 2.19, 19.57; z = 3.36; p < 0008). However, there was significant heterogeneity among the trials.

Conclusions

SILC does not offer any advantage over CLC for treating benign gallbladder disorders. CLC may be used assiduously for this purpose.
Appendix
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Literature
1.
Keus F, de Jong J, Gooszen HG et al (2006) Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database Syst Rev 4:CD006231PubMed
2.
Yuan RH, Lee WJ, Yu SC (1997) Mini-laparoscopic cholecystectomy: a cosmetically better, almost scarless procedure. J Laparoendosc Adv Surg Technol A 7:205–211CrossRef
3.
Sajid MS, Khan MA, Ray K et al (2009) Needlescopic versus laparoscopic cholecystectomy: a meta-analysis. ANZ J Surg 79:437–442PubMedCrossRef
4.
Forgione A, Maggioni D, Sansonna F et al (2008) Transvaginal endoscopic cholecystectomy in human beings: preliminary results. J Laparoendosc Adv Surg Technol A 18:345–351CrossRef
5.
Marescaux J, Dallemagne B, Perretta S et al (2007) Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 142:823–826PubMedCrossRef
6.
Kaouk JH, Haber GP, Goel RK et al (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71:3–6PubMedCrossRef
7.
Zhu JF, Hu H, Ma YZ et al (2009) Transumbilical endoscopic surgery: a preliminary clinical report. Surg Endosc 23:813–817PubMedCrossRef
8.
Hodgett SE, Hernandez JM, Morton CA et al (2009) Laparoendoscopic single site (LESS) cholecystectomy. J Gastrointest Surg 13:188–192PubMedCrossRef
9.
Merchant AM, Cook MW, White BC et al (2009) Transumbilical Gelport access technique for performing single incision laparoscopic surgery (SILS). J Gastrointest Surg 13:159–162PubMedCrossRef
10.
Petrotos AC, Molinelli BM (2009) Single-incision multiport laparoendoscopic (SIMPLE) surgery: early evaluation of SIMPLE cholecystectomy in a community setting. Surg Endosc 23:2631–2634PubMedCrossRef
11.
Tacchino R, Greco F, Matera D (2009) Single-incision laparoscopic cholecystectomy: surgery without a visible scar. Surg Endosc 23:896–899PubMedCrossRef
12.
Gumbs AA, Milone L, Sinha P et al (2009) Totally transumbilical laparoscopic cholecystectomy. J Gastrointest Surg 13:533–534PubMedCrossRef
13.
Langwieler TE, Nimmesgern T, Back M (2009) Single-port access in laparoscopic cholecystectomy. Surg Endosc 23:1138–1141PubMedCrossRef
14.
Gill SI, Advincula AP, Aron M, et al. (2008) White paper: single-site (LESS) surgery. Cited in: Gill SI. Consortium establishes criteria for single port surgery. Ren Urol News
15.
16.
Anonymous (2008) Review Manager (RevMan) [computer program], Version 5.0. Copenhagen, The Nordic Cochrane Centre, The Cochrane Collaboration: Copenhagen
17.
18.
DeMets DL (1987) Methods for combining randomized clinical trials: strengths and limitations. Stat Med 6:341–350PubMedCrossRef
19.
Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558PubMedCrossRef
20.
Egger M, Smith GD, Altman DG (2006) Systematic reviews in healthcare. BMJ Publishing, London
21.
Deeks JJ, Altman DG, Bradburn MJ (2001) Statistical methods for examining heterogeneity and combining results from several studies in meta-analysis. In: Egger M, Smith GD, Altman DG (eds) Systemic Reviews in Health Care: Meta-analysis in Context, 2nd edn. BMJ Publication Group, London, pp 285–312CrossRef
22.
Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12PubMedCrossRef
23.
Chalmers TC, Smith H Jr, Blackburn B et al (1981) A method for assessing the quality of a randomized control trial. Control Clin Trials 2:31–49PubMedCrossRef
24.
25.
Aprea G, Coppola Bottazzi E, Guida F et al (2011) Laparoendoscopic single site (LESS) versus classic video-laparoscopic cholecystectomy: a randomized prospective study. J Surg Res 166:e109–e112PubMedCrossRef
26.
Asakuma M, Hayashi M, Komeda K et al (2011) Impact of single port cholecystectomy on postoperative pain. Br J Surg 98:991–995PubMedCrossRef
27.
Bucher P, Pugin F, Buchs NC et al (2011) Randomized clinical trial of laparoendoscopic single-site versus conventional laparoscopic cholecystectomy. Br J Surg 98:1695–1702PubMedCrossRef
28.
Cao ZG, Cai W, Qin MF et al (2011) Randomized clinical trial of single-incision versus conventional laparoscopic cholecystectomy: short-term operative outcomes. Surg Laparosc Endosc Percutan Tech 21:311–313PubMedCrossRef
29.
Lai EC, Yang GP, Tang CN et al (2011) Prospective randomized comparative study of single incision laparoscopic cholecystectomy versus conventional four-port laparoscopic cholecystectomy. Am J Surg 202:254–258PubMedCrossRef
30.
Lee PC, Lo C, Lai PS et al (2010) Randomized clinical trial of single-incision laparoscopic cholecystectomy versus minilaparoscopic cholecystectomy. Br J Surg 97:1007–1012PubMedCrossRef
31.
Lirici MM, Califano AD, Angelini P et al (2011) Laparo-endoscopic single site cholecystectomy versus standard laparoscopic cholecystectomy: results of a pilot randomized trial. Am J Surg 202:45–52PubMedCrossRef
32.
Ma J, Cassera MA, Spaun GO et al (2011) Randomized controlled trial comparing single-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy. Ann Surg 254:22–27PubMedCrossRef
33.
Phillips MS, Marks JM, Roberts K et al (2011) Intermediate results of a prospective randomized controlled trial of traditional four-port laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy. Surg Endosc 26:1296–1303PubMedCrossRef
34.
Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G et al (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 24:1842–1848PubMedCrossRef
35.
Zheng M, Qin M, Zhao H (2011) Laparoendoscopic single-site cholecystectomy: a randomized controlled study. Minim Invasive Ther Allied Technol 21:113–117PubMedCrossRef
36.
Marks J, Tacchino R, Roberts K et al (2011) Prospective randomized controlled trial of traditional laparoscopic cholecystectomy versus single-incision laparoscopic cholecystectomy: report of preliminary data. Am J Surg 201:369–372PubMedCrossRef
37.
Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery: an overview. Surg Endosc 23:1419–1427PubMedCrossRef
38.
Chamberlain RS, Sakpal SV (2009) A comprehensive review of single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) techniques for cholecystectomy. J Gastrointest Surg 13:1733–1740PubMedCrossRef
39.
Froghi F, Sodergren MH, Darzi A et al (2010) Single-incision laparoscopic surgery (SILS) in general surgery: a review of current practice. Surg Laparosc Endosc Percutan Tech 20:191–204PubMedCrossRef
40.
Greaves N, Nicholson J (2011) Single incision laparoscopic surgery in general surgery: a review. Ann R Coll Surg Engl 93:437–440PubMedCrossRef
41.
Roberts KE, Solomon D, Duffy AJ et al (2010) Single-incision laparoscopic cholecystectomy: a surgeon’s initial experience with 56 consecutive cases and a review of the literature. J Gastrointest Surg 14:506–510PubMedCrossRef
42.
43.
Trichak S (2003) Three-port vs standard four-port laparoscopic cholecystectomy. Surg Endosc 17:1434–1436PubMedCrossRef
44.
Cerci C, Tarhan OR, Barut I et al (2007) Three-port versus four-port laparoscopic cholecystectomy. Hepatogastroenterology 54:15–16PubMed
45.
Kumar M, Agrawal CS, Gupta RK (2007) Three-port versus standard four-port laparoscopic cholecystectomy: a randomized controlled clinical trial in a community-based teaching hospital in eastern Nepal. JSLS 11:358–362PubMed
46.
Poon CM, Chan KW, Lee DW et al (2003) Two-port versus four-port laparoscopic cholecystectomy. Surg Endosc 17:1624–1627PubMedCrossRef
47.
Leung KF, Lee KW, Cheung TY et al (1996) Laparoscopic cholecystectomy: two-port technique. Endoscopy 28:505–507PubMedCrossRef
48.
Steinemann DC, Raptis DA, Lurje G et al (2011) Cosmesis and body image after single-port laparoscopic or conventional laparoscopic cholecystectomy: a multicenter double blinded randomised controlled trial (SPOCC-trial). BMC Surg 11:24PubMedCrossRef
Metadata
Title
Single-Incision Laparoscopic Cholecystectomy Versus Conventional Laparoscopic Cholecystectomy: Meta-analysis and Systematic Review of Randomized Controlled Trials
Authors
Muhammad S. Sajid
Nikhil Ladwa
Lorain Kalra
Kristian K. Hutson
Krishna K. Singh
Mazin Sayegh
Publication date
01-11-2012
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 11/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-012-1719-5

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