Single-incision laparoscopic appendectomy versus conventional laparoscopic appendectomy for adult acute appendicitis: a Meta-analysis for randomized controlled trials

Abstract

To evaluate the efficiency and safety for single-incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA). The literature of randomized controlled trials (RCTs) concerning SILA versus CLA was retrieved by searching the electronic databases from the inception date to May 2014. Methodological quality of the included trials was assessed by using the Cochrane Reviewers' Handbook criteria, and the data were extracted and subjected to Meta-analysis by using RevMan 5.1 analysis software. A total of 1 183 patients were finally selected after the screening. Among them, 582 cases underwent SILA and 601 cases underwent CLA. Meta-analysis results demonstrated that SILA was associated with higher conversion rate (RR=4.38, 95% CI 1.96-9.79, Z=3.59, P=0.0003), longer operative time (RR=4.83, 95% CI 1.57-8.09, Z=2.90, P=0.004), shorter length of hospital stay (WMD=?0.11, 95%CI ?0.21-?0.01, Z=2.02, P=0.04), and better scores for the postoperative appearance of incision (WMD=0.94, 95%CI 0.49-1.40, Z=4.06, P< 0.001) compared with CLA; no significant difference was observed in postoperative complications and postoperative pain scores (RR=1.03, 95% CI 0.74-1.45, Z=0.18, P=0.86; WMD=?0.19, 95%CI ?0.59-0.20, Z=0.95, P=0.34) between the 2 groups. For patients under the conditions of the strict selection, SILA is a safe and effective procedure for the treatment of adult acute appendicitis, especially apply to those who care about incision appearance.