Single-incision versus multiport laparoscopic appendectomy: a case-matched comparative analysis

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• 作者：Jonas Raakow ; Hans-Georg Liesaus ; Peter Neuhaus ; Roland Raakow
• 关键词：Single ; incision laparoscopic surgery ; Single ; port ; Appendectomy ; SILS ; SILA
• 刊名：Surgical Endoscopy
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：29
• 期：6
• 页码：1530-1536
• 全文大小：698 KB
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• 作者单位：Jonas Raakow (1)
  Hans-Georg Liesaus (2)
  Peter Neuhaus (1)
  Roland Raakow (2)
  
  1. Department of General, Visceral and Transplantation Surgery, Universit?tsmedizin Berlin, Charité Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
  2. Department of General, Visceral and Vascular Surgery, Vivantes Klinikum Am Urban, Dieffenbachstrasse 1, 10967, Berlin, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Gynecology
  Gastroenterology
  Hepatology
  Proctology
  Abdominal Surgery
  
• 出版者：Springer New York
• ISSN：1432-2218

文摘

Background The multiport technique is the gold standard for laparoscopic appendectomy, but the use of single-incision laparoscopy is on the increase. The aim of the present study was to compare case-matched cohorts of patients who had undergone single-incision laparoscopic appendectomy (SILA) with those who had undergone conventional multiport laparoscopic appendectomy (MLA). Methods In a case-matched analysis, all single-incision laparoscopic appendectomies performed between July 2009 and December 2013 at one institution were reviewed and compared to multiport laparoscopic appendectomies performed during the same period. Patients who had undergone SILA were matched in terms of age, gender, body mass index (BMI), and American Society of Anesthesiologists (ASA) scores with the same number of patients who had undergone MLA. Statistical evaluation included the description and comparison of demographic factors, details of surgery, and histological data. A univariate analysis was performed to assess potential risk factors for morbidity after SILA. Results One hundred and fifty-six patients who had undergone SILA were reviewed, matched, and compared to the same number of patients who had undergone MLA. No significant difference was noted in mean operating times (50.83 vs. 50.61?min for SILA and MLA, respectively; p?=?0.924) and the length of hospital stay (3.60 vs. 3.66?days; p?=?0.704). No patient in either group required conversion to the open procedure while 6 (3.8?%) SILA patients were converted to multiport laparoscopy. SILA was not associated with significantly higher postoperative morbidity compared to MLA (9.6?% vs. 5.8?%; p?=?0.288). Postoperative wound infection rates were higher after SILA (3.2?% vs. 0.6?%), but did not achieve statistical significance (p?=?0.214). Statistical analysis revealed no risk factors for developing postoperative complications after the single-incision procedure. Conclusion SILA is a technically feasible and safe alternative to conventional MLA. The two procedures did not differ in terms of operating times, length of hospital stay, and postoperative outcomes.