Comparative Study Between Single-Incision and Three-Port Laparoscopic Appendectomy: A Prospective Randomized Trial

Kye, Bong-Hyeon; Lee, Junhyun; Kim, Wook; Kim, Dongjae; Lee, Dosang

doi:10.1089/lap.2012.0284

Cited by 48 publications

(51 citation statements)

References 25 publications

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“…Notably, a recent prospective study comparing SILA and CLA in 102 patients reported that SILA was feasible and safe even in patients with perforated appendices. 16 In the present study, when all patients were included in analysis, the median duration of surgery was 5 minutes longer for patients in the SILA group (median 60.0 min, mean 65.2 min) than the CLA group (median 55.0 min, mean 58.5 min). Our results are similar to those of Kim and colleagues, 8 who reported a mean duration of 61.3 (range 24-120) minutes for SILA, and those of Hong and colleagues, 12 who reported a mean duration of 40.8 (range 15-90) minutes.…”

Section: Discussionmentioning

confidence: 48%

Single-incision versus conventional laparoscopic appendectomy in 688 patients: a retrospective comparative analysis

Liang¹,

Hung²,

Wang³

et al. 2014

Can J Surg

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Background: Laparoscopic surgery has become the standard for treating appendicitis. The cosmetic benefits of using single-incision laparoscopy are well known, but its duration, complications and time to recovery have not been well documented. We compared 2 laparoscopic approaches for treating appendicitis and evaluated postoperative pain, complications and time to full recovery. Methods:We retrospectively reviewed the cases of consecutive patients with appendicitis and compared those who underwent conventional laparoscopic appendectomy (CLA) performed using 3 incisions and those who underwent single-incision laparoscopic appendectomy (SILA). During SILA, the single port was prepared to increase visibility of the operative site.Results: Our analysis included 688 consecutive patients: 618 who underwent CLA and 70 who underwent SILA. Postsurgical complications occurred more frequently in the CLA than the SILA group (18.1% v. 7.1%, p = 0.018). Patients who underwent SILA returned to oral feeding sooner than those who underwent CLA (median 12 h v. 22 h, p < 0.001). These between-group differences remained significant after controlling for other factors. Direct comparison of only nonperforated cases, which was determined by pathological examination, revealed that SILA was significantly longer than CLA (60 min v. 50 min, p < 0.001). Patients who underwent SILA had longer in-hospital stays than those who underwent CLA (72 v. 55 h, p < 0.001); however, they had significantly fewer complications (3.0% v. 14.4%, p = 0.006). Conclusion:In addition to its cosmetic advantages, SILA led to rapid recovery and no increase in postsurgical pain or complications.Contexte : La chirurgie laparoscopique est devenue la norme pour le traitement de l'appendicite. Les avantages de la laparoscopie à simple incision au plan esthétique sont bien connus, mais la durée de l'intervention, ses complications et le temps de récupération n'ont pas été adéquatement documentés. Nous avons comparé 2 approches laparoscopiques pour le traitement de l'appendicite et évalué la douleur et les complications postopératoires, de même que le temps de récupération complète.Méthodes : Nous avons passé en revue de manière rétrospective les dossiers de patients consécutifs atteints d'appendicite et comparé ceux qui ont subi une appendicectomie laparoscopique classique (ALC) à 3 incisions à ceux qui ont subi une appendicectomie laparoscopique à simple incision (ALSI). Durant l'ALSI, l'incision était préparée de manière à améliorer la visibilité du champ opératoire.Résultats : Notre analyse a inclus 688 patients consécutifs : 618 qui ont subi une ALC et 70, une ALSI. Les complications postopératoires ont été plus nombreuses dans le groupe soumis à l'ALC qu'à l'ALSI (18,1 % c. 7,1 %, p = 0,018). Les patients soumis à l'ALSI ont repris l'alimentation orale plus rapidement que ceux qui avaient subi une ALC (temps médian 12 h c. 22 h, p < 0,001). Ces différences entre les groupes sont demeurées significatives après incorporation d'autres facteurs. La comparaison directe...

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Section: Discussionmentioning

confidence: 48%

Single-incision versus conventional laparoscopic appendectomy in 688 patients: a retrospective comparative analysis

Liang¹,

Hung²,

Wang³

et al. 2014

Can J Surg

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“…2 Kye at al reported that pain score on the visual analog scale on postoperative Day 1 was significantly lower in the single-incision group than in the three-port group. 3 Lee AJ at al reported that no significant difference noted for mean operative time for Single incision laparoscopy group and conventional laparoscopy group. 4 One patient in single incision laparoscopy group had wound infection which was treated with antibiotics and re admission was not required.…”

Section: Discussionmentioning

confidence: 95%

“…There are only ongoing trials available, some of which will be complete prior to this study's conclusion. 3 The aim was to compare the outcome of single incision multiport laparoscopic appendectomy vs conventional laparoscopic appendicectomy in terms of patient recovery time, post-operative pain, wound complications, duration of the procedure and patient satisfaction as regards cosmesis.…”

Section: Introductionmentioning

confidence: 99%

A comparative study between single incision multiport laparoscopic appendicectomy and conventional laparoscopic appendicectomy in tertiary care hospital, Kanchipuram District, Tamil Nadu, India

Babu¹,

Kumar²

2017

Int Surg J

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Background: To compare the outcome of single incision multiport laparoscopic appendectomy versus conventional laparoscopic appendicectomy in terms of patient recovery time, post-operative pain in Karpaga Vinayaga Medical College and Hospital, Kanchipuram District, Tamil Nadu, India.Methods: A randomized control study was done by alternation with sample size of 50 which divided into two groups (study group 25 and control group 25) and study period is from August 2012 to September 2014.Results: Patient in single incision laparoscopy group show less post-operative pain in the first 6 and 12 hours compared to the conventional laparoscopy group, but no difference was noticed between the two groups after 24 hours. No significant difference in operating times was noted between the procedures.Conclusions: One patient in 25 who underwent single incision laparoscopy had wound infection, but no wound complications were noted in the conventional appendicectomy group. Patients underwent Single incision laparoscopy are happier with scar when compared with conventional laparoscopy group. No difference noted in the duration of post-operative hospital stay.

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“…However, this was not statistically significant in which SILA group required less morphine in recovery. Another two study reported significant difference on pain score in favor of the SILA group during the first 24 h [21,22]. Teoh et al [16] described no significant differences in pain score when evaluated at rest but a decrease in this score in the CLA group during coughing and standing.…”

Section: Discussionmentioning

confidence: 96%

“…According to the studies conducted by Teoh [16,18,[20][21][22][23] the results showed that SILA was associated with significant longer operative times than 3-port LA. More time is needed for performing SILA than 3PLA may be due to the characteristic single incision of SILA technique would increase its technical difficulty because all surgical procedures have to be performed in one working channel [18,24].…”

Section: Operative Timementioning

confidence: 99%

Can Single Incision Laparoscopic Appendectomy Replace the Traditional Three Port Laparoscopic Approach in Coming Future: A Review

Chand¹,

Ling²

2015

Surgery

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Journal of Surgery[ IntroductionMedicine is an ever-changing and ever-growing field where day after day and year after year new things are invented, applied for the treatment of various diseases. In the line of treatment, surgery has been one of the feared treatment options for most of the patients; therefore surgeons try to provide the patients with the best possible surgical treatment options. The best possible surgical option has always been the one with the lesser complications intra and postoperatively, wellcontrolled pain, less stay at hospital etc. Both doctors and patient don't want to maximize hospital stay as one study stated that extended hospital stay has been associated with increased incidence of hospital acquired infections, which causes further increase in morbidity and mortality [1]. One of the greatest achievements in the history of surgery has been evolved from open surgical techniques to the operative video-laparoscopy Acute appendicitis is one of the most common cause of acute abdomen and one of the most common surgical emergencies. Appendectomy for acute appendicitis is one of the most commonly performed surgical procedures [2]. The surgical technique of first open appendectomy (OA) was performed by Dr. Charles Mcburney in and this approach has not significantly changed in the last 1 century [3]. In 1983, Dr. Kurt Semm, performed first minimally invasive laparoscopic appendectomy, thereafter LA has become the standard of practice in uncomplicated appendectomies in most minimally invasive institution [4]. In the past few years of minimally invasive surgery, LESS, NOTES has gained popularity. SILA was first described in 1998 by Esposito and has gained popularity as a method with a concept of ''scarless'' abdomen [5]. While Pelosi in 1992 performed the first SILA for acute appendicitis [6]. Innovative methods such as NOTES (Natural Orifice Tran luminal Endoscopic Surgery) and single incision laparoscopy (SIL) have demonstrated promissory results in various surgical procedures, appendectomy among them [7]. According to a recent study, SILA resulted in faster recovery than conventional 3-port LA [8]. However in some other studies it has also been reported that SILS is associated with a longer operative time and higher postoperative pain scores, and that patients need more analgesics to feel comfortable [9]. NOTES, SILS, and robotic surgery do not constitute techniques, rather they are concepts, hence regarded as transitions from laparoscopic surgery to unknown fields of minimally invasive therapeutic modalities [10]. SILS was recommended as a possible alternative of the traditional laparoscopic surgery via four ports for the biliary tact by Navarra et al. [11]. With NOTES having a diminished success, because of the inability to find a clean site for access, thereby increasing the chances of intra-abdominal spillage or infection from the incision [12] increased interest has been seen in SILS. SILS occupies a space between NOTES and standard laparoscopy [13]. There have been several studies regard...

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Comparative Study Between Single-Incision and Three-Port Laparoscopic Appendectomy: A Prospective Randomized Trial

Cited by 48 publications

References 25 publications

Single-incision versus conventional laparoscopic appendectomy in 688 patients: a retrospective comparative analysis

Single-incision versus conventional laparoscopic appendectomy in 688 patients: a retrospective comparative analysis

A comparative study between single incision multiport laparoscopic appendicectomy and conventional laparoscopic appendicectomy in tertiary care hospital, Kanchipuram District, Tamil Nadu, India

Can Single Incision Laparoscopic Appendectomy Replace the Traditional Three Port Laparoscopic Approach in Coming Future: A Review

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