Conventional Laparoscopic Appendectomy Versus Single-Port Laparoscopic Appendectomy, a Multicenter Randomized Control Trial: A Feasible and Safe Alternative to Standard Laparoscopy

Duza, Guillermo; Davrieux, Carlos Federico; Palermo, Mariano; Khiangte, Elbert; Azfar, Mohamad; Rizvi, Syed Amjad Ali; Trelles, Nelson; Zorraquín, Carlos; Sbaï-Idrissi, Mohamed Saïd; Alban, Zarzavadjian Le Brian

doi:10.1089/lap.2019.0460

Cited by 24 publications

(17 citation statements)

References 26 publications

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“…In this context, as mentioned above, there are controversies about the e cacy of SILA with respect to cosmetic satisfaction and pain reduction compare to CLA. However, previous studies including RCTs have used only a simple VAS and/or analgesic usage as indicators for pain reduction [8,10,24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Theoretically, SILA would be expected to produce less pain, encourage faster recovery, and result in better cosmetic satisfaction than CLA. However, several previous reports comparing SILA and CLA have yielded con icting results and only a few studies have reported that SILA is superior to CLA with respect to pain and/or cosmesis [7][8][9][10][11]. One randomized control trial (RCT) failed to show the superiority of SILA over CLA with respect to pain and cosmesis [12].…”

Section: Introduction Background and Rationale {6a}mentioning

confidence: 99%

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Single-Incision Versus Conventional Laparoscopic Appendectomy: A Multi-Center Randomized Controlled Trial (SCAR Trial)

Kang

Woo

Bae

et al. 2021

Preprint

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Background: Although single-incision laparoscopic appendectomy (SILA) was introduced decades ago, it is still considered a difficult technique to perform compared to conventional laparoscopic appendectomy (CLA). In addition, controversy about the benefits of SILA compared to CLA abounds and no definite criteria for choosing SILA over CLA in patients with appendicitis currently exist. Therefore, we have planned a multi-center randomized controlled trial to compare SILA with CLA in terms of cosmetic satisfaction and pain reduction. Methods: Patients diagnosed with appendicitis at the participating centers will be recruited and allocated into either a CLA or an SILA groups using a 1:1 randomization. Patients in the CLA group will receive a conventional 3-port laparoscopic appendectomy and patients in the SILA group will receive a laparoscopic appendectomy using a single-incision at the umbilicus. The primary trial endpoint is cosmetic satisfaction assessed using the Patients and Observer Scar Assessment Scale (POSAS) at 6 weeks after surgery. Secondary trial endpoints include cosmetic satisfaction assessed via the Body Image Questionnaire, pain levels assessed via the Visual Analog Scale and International Pain Outcomes questionnaire, and the presence of postoperative complications. The target sample size of this superiority trial is 120 patients, as this will provide 80% power at the 2.5% level of significance to detect a 3-point difference in POSAS. Discussion: The results of this planned multi-center randomized controlled trial will provide substantive evidence to help surgeons choose when to use SILA over CLA in patients with appendicitis.Trial registration: Clinical Research Information Service (CRIS), Registered on 21 May, 2020 (KCT0005048). https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=16171

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Section: Discussionmentioning

confidence: 99%

Section: Introduction Background and Rationale {6a}mentioning

confidence: 99%

Single-Incision Versus Conventional Laparoscopic Appendectomy: A Multi-Center Randomized Controlled Trial (SCAR Trial)

Kang

Woo

Bae

et al. 2021

Preprint

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“…Single-incision laparoscopic appendectomy (SILA) is presently the most frequently performed single-incision laparoscopic procedure [12][13][14][15][16]. Surgical stress in SILA is theoretically lower than that in colon resection surgery.…”

Section: Introductionmentioning

confidence: 99%

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis

et al. 2021

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The objective of this study was to compare the perioperative outcomes between single incision laparoscopic appendectomy (SILA) and three port appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol. Methods: Of 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution's ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM). Results: After 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2±0.8 vs. 1.6±0.8 days, p =0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, p =0.1) and the postoperative visual analogue scores for pain at 6 hours (2.4±1.9 vs. 2.8±1.4, p = 0.260) and 12 hours (2.4±2.0 vs. 2.9±1.5, p=0.257) did not show significant difference between the two groups. Conclusion: SILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.

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“…2 This technique been widely applied in appendectomy, gastric binding, colectomy, donor nephrectomy, and sleeve gastrectomy. [3][4][5][6] It seems to be a no scar surgery because the entry point is hidden in the umbilicus. When compared with multiport laparoscopic surgery, SILC shows better cosmetic outcomes, post-operative pain control, and patient satisfaction, as well as shorter hospital stays.…”

Section: Introductionmentioning

confidence: 99%

Comparison of outcomes of single incision robotic cholecystectomy and single incision laparoscopic cholecystectomy

Lee

Lim

2021

Ann Hepatobiliary Pancreat Surg

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Backgrounds/Aims: Multiport laparoscopic cholecystectomy is the standard surgical procedure for symptomatic gallbladder diseases. However, as a result of the ongoing trend toward minimally invasive laparoscopy, single-incision laparoscopic cholecystectomy (SILC) has evolved. Single-incision robotic cholecystectomy (SIRC) can overcome several limitations of manual SILC. The purpose of this study is to evaluate and compare the safety and feasibility of SIRC and SILC. Methods: This study retrospectively reviewed data for all patients who underwent SIRC or SILC from March 2018 to July 2019 in a single institution. The following variables were analyzed: age, sex, body mass index, pain scale, length of stay, and complications. The data were analyzed using the Independent two sample t-test or the Fisher's exact test. Results: A total of 343 patients underwent SIRC or SILC during the study period. After excluding patients with acute cholecystitis, 197 SIRC and 103 SILC patients were analyzed in this study. The surgery time and postoperative hospital stay did not differ between SIRC and SILC. However, the SIRC patients experienced less bile spillage during the surgery than did the SILC patients (SIRC vs. SILC: 24 (23.3%) vs. 11 (5.6%) cases, respectively; p＜0.001). Although there was no difference in the incidence of postoperative complications between procedures, additional pain control was administered more frequently in SILC patients (SILC 1.08±0.893, SIRC 0.58±0.795; p＜0.001). Conclusions: While both SILC and SIRC are effective for single-incision cholecystectomy, SIRC was superior to SILC in terms of technical stability. Moreover, it has the advantage of postoperative pain control.

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Conventional Laparoscopic Appendectomy Versus Single-Port Laparoscopic Appendectomy, a Multicenter Randomized Control Trial: A Feasible and Safe Alternative to Standard Laparoscopy

Cited by 24 publications

References 26 publications

Single-Incision Versus Conventional Laparoscopic Appendectomy: A Multi-Center Randomized Controlled Trial (SCAR Trial)

Single-Incision Versus Conventional Laparoscopic Appendectomy: A Multi-Center Randomized Controlled Trial (SCAR Trial)

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis

Comparison of outcomes of single incision robotic cholecystectomy and single incision laparoscopic cholecystectomy

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