A Systematic Review and Pooled Analysis of Single Incision Laparoscopic Appendectomy

Richdeep S Gill, MD, Xinzhe Shi, MPH, David P Al-adra, MD, Daniel W Birch, MD MSc FRCPS, Shahzeer Karmali, MD FRCPS. University of Alberta; Royal Alexandria Hospital

 

Purpose:

Acute appendicitis remains the common gastrointestinal emergency in adults. Single incision laparoscopic appendectomy (SILA) has been proposed as the next evolution in minimally invasive surgery. SILA is postulated to reduce post-operative pain and enhance cosmesis, while effectively removing an inflamed appendix.. However the efficacy and benefits of SILA compared to conventional laparoscopic appendectomy (CLA) remain to be determined. Our objectives were to systematically review the literature comparing SILA to CLA for acute appendicitis and perform a pooled analysis on the efficacy of SILA.

Methods:

Published English-language manuscripts were considered for review inclusion. A comprehensive search of electronic databases (e.g., MEDLINE, EMBASE, SCOPUS, BIOSIS Previews and the Cochrane Library) using broad search terms was completed. All comparative studies were included if they incorporated adult patients undergoing appendectomy for acute appendicitis by SILA. The primary outcomes of interest were operative time and length of hospital stay (LOS).

Results:

From a total of 366 articles, 34 articles were identified. A total of nine comparative studies were included for pooled analysis. There was no significant difference in operative time, LOS, pain scores, conversion or complication rates between SILA and CLA for acute appendicitis.

Conclusion:

This systematic review and pooled analysis demonstrates that SILA is comparable to CLA for acute appendicitis in adults. However, this review identifies the need for randomized controlled trials to clarify the efficacy of SILA compared to CLA.


Session Number: Poster – Poster Presentations
Program Number: P024
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