Single-incision Laparoscopic Appendectomy Versus Conventional Laparoscopic Appendectomy: Experiences From 1208 Cases of Single-incision Laparoscopic Appendectomy

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Objective:Currently single-incision laparoscopic appendectomy (SIL-A) has become an option for treating appendicitis. The aim of this study was to evaluate the safety and feasibility of SIL-A compared with conventional laparoscopic appendectomy (CL-A) on a large experimental cohort.Background:Several studies had reported the safety and technical feasibility of SIL-A, albeit with a limited number of study subjects.Methods:A total of 2587 patients (1208 SIL-A and 1379 CL-A) who underwent laparoscopic appendectomy from May 2008 to April 2013 were studied retrospectively. The clinical characteristics and short-term operative outcomes of these patients were reviewed and analyzed.Results:There were more simple type appendicitis in the SIL-A group and more complicated type appendicitis in CL-A group (81.0% vs 74.7% and 19% vs 25.3%, P <0.001, respectively). The operative time (minutes) was similar between the 2 groups (40.1 ± 18.6 vs 38.8 ± 25.2, P = 0.154). However, on subgroup analysis, operative time for simple type appendicitis was longer in the SIL-A group (36.6 ± 14.9 vs 32.3 ± 18.3, P < 0.001). The superficial incisional surgical site infection rate was higher in the SIL-A group (4.4% vs 2.3%, P = 0.003). The readmission rate was higher in the CL-A group (0.8% vs 1.7%, P = 0.042). The postoperative hospital stay (days) was shorter in the SIL-A group (3.05 ± 1.97 vs 3.35 ± 2.14, P < 0.001).Conclusions:In this study, SIL-A was technically feasible and safe option for appendicitis. The SIL-A group had more favorable outcomes such as shorter time to start diet and less hospital stay after surgery than the CL-A group. However, superficial incisional surgical site infection rate was higher in the SIL-A group than in the CL-A group, an effort to reduce superficial incisional SSI should be made.

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