Single Incision versus Conventional Multiport Laparoscopic Appendectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zhou, Haiyang; Jin, Kaizhou; Zhang, Jian; Sun, Yanping; Ruan, Canping; Hu, Zhiqian

doi:10.1159/000369217

Cited by 19 publications

(10 citation statements)

References 30 publications

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“…The disadvantage is the fact that SILS is a more difficult technique as is reflected by the higher technical failure rate, longer operating time and conversion rate [71–78]. Main advantages of SILS would be less post-operative pain and better cosmetic outcomes, although inconsistent results have been reported [71, 75, 76, 79–81]. At the present time, evidence is lacking that SILS is superior to conventional LA [79, 82, 83].…”

Section: Pre-operative Carementioning

confidence: 99%

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

et al. 2016

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Unequivocal international guidelines regarding the diagnosis and management of patients with acute appendicitis are lacking. The aim of the consensus meeting 2015 of the EAES was to generate a European guideline based on best available evidence and expert opinions of a panel of EAES members. After a systematic review of the literature by an international group of surgical research fellows, an expert panel with extensive clinical experience in the management of appendicitis discussed statements and recommendations. Statements and recommendations with more than 70 % agreement by the experts were selected for a web survey and the consensus meeting of the EAES in Bucharest in June 2015. EAES members and attendees at the EAES meeting in Bucharest could vote on these statements and recommendations. In the case of more than 70 % agreement, the statement or recommendation was defined as supported by the scientific community. Results from both the web survey and the consensus meeting in Bucharest are presented as percentages. In total, 46 statements and recommendations were selected for the web survey and consensus meeting. More than 232 members and attendees voted on them. In 41 of 46 statements and recommendations, more than 70 % agreement was reached. All 46 statements and recommendations are presented in this paper. They comprise topics regarding the diagnostic work-up, treatment indications, procedural aspects and post-operative care. The consensus meeting produced 46 statements and recommendations on the diagnostic work-up and management of appendicitis. The majority of the EAES members supported these statements. These consensus proceedings provide additional guidance to surgeons and surgical residents providing care to patients with appendicitis. Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5245-7) contains supplementary material, which is available to authorized users.

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Section: Pre-operative Carementioning

confidence: 99%

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

et al. 2016

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“…However, in recent years, laparoscopic appendectomy has been widely performed, and now, single‐incision laparoscopic appendectomies are commonly performed. This surgical approach is minimally invasive and produces excellent cosmetic outcomes .…”

Section: Introductionmentioning

confidence: 99%

Transumbilical laparoscopic appendectomy performed by residents is safe and feasible

Endo

Kujirai

Maeda

et al. 2016

Asian J Endoscop Surgery

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“…It is possible that small defects in the foam's surface that are created during repeated use may cause an increase in mechanical irritation to tissues, predisposing to seromas, or may harbor bacteria, increasing the risk of infection. In addition, because the SILS port does not allow for instrument triangulation, it may result in an increase in instrument interference in comparison to multiport surgery . Application of torque to the SILS port to avoid instrument interference may contribute to mechanical irritation to surrounding tissues.…”

Section: Discussionmentioning

confidence: 99%

“…Single‐incision–port systems have gained popularity for human laparoscopic surgery because of the cosmetic appeal of procedures performed through a single incision. In several trials comparing single‐incision port with multiple‐port procedures, researchers have demonstrated that single‐incision port procedures result in longer operative times, in part because of lack of triangulation. Despite this, a difference in complication rates between single‐incision–port and multiple‐port procedures has not been shown in most human studies, although, in one retrospective study, a higher infection rate was observed in cholecystectomy patients undergoing a single‐incision–port robotic procedure than in patients undergoing a multiple‐port procedure .…”

Section: Discussionmentioning

confidence: 99%

Paramedian incisional complications after prophylactic laparoscopy‐assisted gastropexy in 411 dogs

et al. 2019

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Objective To determine the frequency and types of paramedian incisional complications after prophylactic laparoscopy‐assisted gastropexy (LAG) in dogs and to evaluate potential risk factors for complications. Study design Multi‐institutional retrospective study. Animals Client‐owned dogs (N = 411). Methods Records for dogs that underwent single‐incision–port laparoscopy‐assisted gastropexy (SIPLAG) or multiple‐port laparoscopy‐assisted gastropexy (MPLAG) at five veterinary referral hospitals were reviewed. Information regarding signalment, surgical procedures, perioperative care, and incisional complications was collected. Follow‐up information was obtained by review of medical records and/or communication with owners. Potential risk factors for complications were examined statistically. Results Paramedian incisional complications were observed in 78 of 411 (19%) dogs. The most common complication was seroma formation, which occurred in 51 (12.4%) dogs. Surgical site infections were observed in 16 (3.9%) dogs, and dehiscence or development of excessive scar tissue at the incision site were each observed in nine (2.2%) dogs. Complications resolved with conservative treatment in 75 of 78 (96.2%) dogs and with surgical treatment in three of 78 (3.8%) dogs. The odds of complications were approximately twice as high in dogs undergoing SIPLAG than in dogs undergoing MPLAG (odds ratio, 2.03; P = .006). Conclusion Minor paramedian incisional complications, particularly seroma formation, were frequently observed after LAG. Most complications were successfully managed conservatively. Single‐incision–port laparoscopy‐assisted gastropexy was associated with a higher complication rate compared with MPLAG. Clinical significance Owners should be informed that there is a relatively high rate of minor paramedian incisional complications after LAG. The risk of complications appears to be higher for SIPLAG than for MPLAG.

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Single Incision versus Conventional Multiport Laparoscopic Appendectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cited by 19 publications

References 30 publications

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

Diagnosis and management of acute appendicitis. EAES consensus development conference 2015

Transumbilical laparoscopic appendectomy performed by residents is safe and feasible

Paramedian incisional complications after prophylactic laparoscopy‐assisted gastropexy in 411 dogs

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