Shintaro Kohama, Masaki Fukunaga, Tetsu Fukunaga, Kunihiko Nagakari, Yoshito Iida, Seiichiro Yoshikawa, Masakazu Ouchi, Goutaro Katsuno, Satoshi Kanda, Yuji Ishibashi, Yoshinori Hirasaki, Daisuke Azuma, Yoshinori Kohira, Jun Nomoto. Department of Surgery, Juntendo Urayasu Hospital
Background: We usually perform single-incision laparoscopic appendectomy (SILA) in selected patients. The aim of this study is to evaluate the short-term outcomes of SILA compared with conventional laparoscopic appendectomy (CLA) by using propensity score matching analysis.
Surgical indications and techniques: SILA is basically performed in uncomplicated appendicitis by using similar surgical technique to CLA. We usually adopt a 2 cm Z-type skin incision. Multi-access platform is placed in this umbilical incision area. All CLA cases are performed using 3 trocars method.
Design: The study group included 173 patients who underwent SILA and 297 patients who underwent CLA between January 2009 and June 2016. The propensity score matching for age, gender, body mass index, preoperative WBC counts, preoperative CRP levels, appendicitis with abscess formation or diffuse peritonitis and previous major abdominal surgery produced 58 matched pairs.
Results: As for baseline characteristics, there were no statistically significant differences between SILA (n=58) and CLA (n=58) groups. No significant differences were observed in operating time, bleeding volumes, starting time of oral intake, length of hospital stay, analgesic requirements and pathological findings between the SILA and CLA. The overall rate of SILA and CLA was 5.17 and 3.45% (p=0.65). Among them, enteritis was similar in both groups (3.45%). One patient had wound infection (1.72%) in the SILA.
Conclusion: This study indicates that SILA is a safe and feasible option with better cosmetic results in uncomplicated appendicitis.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79092
Program Number: P245
Presentation Session: Poster (Non CME)
Presentation Type: Poster
