Single-incision versus conventional three-port laparoscopic appendectomy for acute appendicitis: A meta-analysis of randomized controlled trials
While consensus on single-incision laparoscopic appendectomy (SILA) for acute appendicitis is lacking, our meta-analysis evaluated the safety and efficacy of SILA compared to conventional three-port laparoscopic appendectomy (CTLA). A computer-based search was conducted in the China National Knowled...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Asian Journal of Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958423021474 |
| _version_ | 1827360942891991040 |
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| author | Yin Han Hao Yuan Shuang Li Wei-Fa Wang |
| author_facet | Yin Han Hao Yuan Shuang Li Wei-Fa Wang |
| author_sort | Yin Han |
| collection | DOAJ |
| description | While consensus on single-incision laparoscopic appendectomy (SILA) for acute appendicitis is lacking, our meta-analysis evaluated the safety and efficacy of SILA compared to conventional three-port laparoscopic appendectomy (CTLA). A computer-based search was conducted in the China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biological Medicine (CBM), PubMed, Embase, and Cochrane Library databases to identify randomized controlled trials (RCTs) comparing SILA with CTLA groups. Meta-analysis was performed using RevMan 5.3 software. A total of 26 RCTs were included. The meta-analysis results indicated that, compared to the CTLA group, the SILA group had a longer operation time [MD = 7.97, 95 % CI (5.84, 10.10), P < 0.00001], and a higher rate of conversion to open surgery [RR = 2.60, 95 % CI (1.27, 5.31), P = 0.009], but had a shorter time to return to normal activities [MD = −0.76, 95 % CI (−1.15, −0.37), P = 0.0001]. Additionally, the SILA group had higher satisfaction scores [SMD = 1.21, 95 % CI (0.75, 1.68), P < 0.00001] and cosmetic scores [SMD = 0.68, 95 % CI (0.45, 0.90), P < 0.00001]. There was no significant difference between the two groups in terms of pain scores at 24 h postoperatively [MD = −0.21, 95 % CI (−0.56, 0.14), P = 0.25], the incidence of wound infection [RR = 1.13, 95 % CI (0.74, 1.73), P = 0.58], or the overall complication rate [RR = 0.86, 95 % CI (0.66, 1.12), P = 0.27]. SILA is a safe and effective surgical approach that allows patients to recover to normal activities earlier, particularly for patients with a strong demand for better cosmetic outcomes. However, the quality of some RCTs in this meta-analysis is low, and further verification is needed through future high-quality RCTs. |
| first_indexed | 2024-03-08T06:56:44Z |
| format | Article |
| id | doaj.art-40c427ae6f9c45128963e44449deaa8b |
| institution | Directory Open Access Journal |
| issn | 1015-9584 |
| language | English |
| last_indexed | 2024-03-08T06:56:44Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj.art-40c427ae6f9c45128963e44449deaa8b2024-02-03T06:35:18ZengElsevierAsian Journal of Surgery1015-95842024-02-01472864873Single-incision versus conventional three-port laparoscopic appendectomy for acute appendicitis: A meta-analysis of randomized controlled trialsYin Han0Hao Yuan1Shuang Li2Wei-Fa Wang3Corresponding author. Department of Gastrointestinal surgery, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, 610200, Sichuan, China.; Department of Gastrointestinal Surgery, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, 610200, Sichuan, ChinaDepartment of Gastrointestinal Surgery, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, 610200, Sichuan, ChinaDepartment of Gastrointestinal Surgery, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, 610200, Sichuan, ChinaDepartment of Gastrointestinal Surgery, Chengdu Seventh People's Hospital (Affiliated Cancer Hospital of Chengdu Medical College), Chengdu, 610200, Sichuan, ChinaWhile consensus on single-incision laparoscopic appendectomy (SILA) for acute appendicitis is lacking, our meta-analysis evaluated the safety and efficacy of SILA compared to conventional three-port laparoscopic appendectomy (CTLA). A computer-based search was conducted in the China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biological Medicine (CBM), PubMed, Embase, and Cochrane Library databases to identify randomized controlled trials (RCTs) comparing SILA with CTLA groups. Meta-analysis was performed using RevMan 5.3 software. A total of 26 RCTs were included. The meta-analysis results indicated that, compared to the CTLA group, the SILA group had a longer operation time [MD = 7.97, 95 % CI (5.84, 10.10), P < 0.00001], and a higher rate of conversion to open surgery [RR = 2.60, 95 % CI (1.27, 5.31), P = 0.009], but had a shorter time to return to normal activities [MD = −0.76, 95 % CI (−1.15, −0.37), P = 0.0001]. Additionally, the SILA group had higher satisfaction scores [SMD = 1.21, 95 % CI (0.75, 1.68), P < 0.00001] and cosmetic scores [SMD = 0.68, 95 % CI (0.45, 0.90), P < 0.00001]. There was no significant difference between the two groups in terms of pain scores at 24 h postoperatively [MD = −0.21, 95 % CI (−0.56, 0.14), P = 0.25], the incidence of wound infection [RR = 1.13, 95 % CI (0.74, 1.73), P = 0.58], or the overall complication rate [RR = 0.86, 95 % CI (0.66, 1.12), P = 0.27]. SILA is a safe and effective surgical approach that allows patients to recover to normal activities earlier, particularly for patients with a strong demand for better cosmetic outcomes. However, the quality of some RCTs in this meta-analysis is low, and further verification is needed through future high-quality RCTs.http://www.sciencedirect.com/science/article/pii/S1015958423021474AppendicitisAppendectomySingle-incision laparoscopyMeta-analysis |
| spellingShingle | Yin Han Hao Yuan Shuang Li Wei-Fa Wang Single-incision versus conventional three-port laparoscopic appendectomy for acute appendicitis: A meta-analysis of randomized controlled trials Asian Journal of Surgery Appendicitis Appendectomy Single-incision laparoscopy Meta-analysis |
| title | Single-incision versus conventional three-port laparoscopic appendectomy for acute appendicitis: A meta-analysis of randomized controlled trials |
| title_full | Single-incision versus conventional three-port laparoscopic appendectomy for acute appendicitis: A meta-analysis of randomized controlled trials |
| title_fullStr | Single-incision versus conventional three-port laparoscopic appendectomy for acute appendicitis: A meta-analysis of randomized controlled trials |
| title_full_unstemmed | Single-incision versus conventional three-port laparoscopic appendectomy for acute appendicitis: A meta-analysis of randomized controlled trials |
| title_short | Single-incision versus conventional three-port laparoscopic appendectomy for acute appendicitis: A meta-analysis of randomized controlled trials |
| title_sort | single incision versus conventional three port laparoscopic appendectomy for acute appendicitis a meta analysis of randomized controlled trials |
| topic | Appendicitis Appendectomy Single-incision laparoscopy Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S1015958423021474 |
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