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Single-port laparoscopic surgery in acute appendicitis: retrospective comparative analysis for 618 patients

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Abstract

Background

Transumbilical single-port laparoscopic appendectomy (SPLA) is a promising procedure that features less pain, faster recovery of postoperative bowel function and superior cosmetic results. We performed a retrospective comparative analysis of SPLA versus conventional laparoscopic surgery (CLA) to evaluate the safety and efficacy in acute appendicitis.

Methods

From December 2008 to November 2013, laparoscopic surgery was performed on 636 patients with acute appendicitis at the Department of Surgery, Chuncheon Sacred Heart Hospital. Under approval of Institutional Review Board, data concerning baseline characteristics, operative outcomes, postoperative complications and postoperative functional recovery were compared between both procedures.

Results

After exclusion of 18 patients, 618 patients treated for acute appendicitis were included. SPLA was performed in 375 patients and CLA in 243 patients. Complicated appendicitis was more prevalent in the CLA group (26.3 %) than in the SPLA group (17.1 %) (p = 0.005). There was no difference between groups in operation time (p = 0.235), postoperative duration of hospital stay (p = 0.672) and readmission rate (p = 0.688). The rate of postoperative complications was similar in both groups (10.7 % in SPLA vs. 11.1 % in CLA, p = 0.862). In subgroup analysis of complicated appendicitis, more patients needed conversion to open surgery in the SPLA group (15.6 vs. 1.6 %, p = 0.005).

Conclusion

In uncomplicated appendicitis, SPLA can be performed safely and efficiently. However, more selective indication for SPLA should be applied in cases of complicated appendicitis because of the greater risk of open conversion.

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References

  1. Kim SJ, Choi BJ, Lee SC (2014) Overview of single-port laparoscopic surgery for colorectal cancers: past, present, and the future. World J Gastroenterol 20:997–1004

    Article  PubMed  PubMed Central  Google Scholar 

  2. Xu AM, Huang L, Li TJ (2015) Single-incision versus three-port laparoscopic appendectomy for acute appendicitis: systematic review and meta-analysis of randomized controlled trials. Surg Endosc 29:822–843

    Article  PubMed  Google Scholar 

  3. Pokala N, Sadhasivam S, Kiran RP, Parithivel V (2007) Complicated appendicitis—is the laparoscopic approach appropriate? A comparative study with the open approach: outcome in a community hospital setting. Am Surg 73:737–741 (discussion 741–732)

    PubMed  Google Scholar 

  4. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M (2009) The Clavien–Dindo classification of surgical complications: five-year experience. Ann Surg 250:187–196

    Article  PubMed  Google Scholar 

  5. Diana M, Dhumane P, Cahill RA, Mortensen N, Leroy J, Marescaux J (2011) Minimal invasive single-site surgery in colorectal procedures: current state of the art. J Minim Access Surg 7:52–60

    PubMed  PubMed Central  Google Scholar 

  6. Semm K (1983) Endoscopic appendectomy. Endoscopy 15:59–64

    Article  CAS  PubMed  Google Scholar 

  7. Ohtani H, Tamamori Y, Arimoto Y, Nishiguchi Y, Maeda K, Hirakawa K (2012) Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis. J Gastrointest Surg 16:1929–1939

    Article  PubMed  Google Scholar 

  8. Wei B, Qi CL, Chen TF, Zheng ZH, Huang JL, Hu BG, Wei HB (2011) Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis. Surg Endosc 25:1199–1208

    Article  PubMed  Google Scholar 

  9. Lee YS, Kim JH, Moon EJ, Kim JJ, Lee KH, Oh SJ, Park SM, Hong TH (2009) Comparative study on surgical outcomes and operative costs of transumbilical single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy in adult patients. Surg Laparosc Endosc Percutan Tech 19:493–496

    Article  PubMed  Google Scholar 

  10. Carter JT, Kaplan JA, Nguyen JN, Lin MY, Rogers SJ, Harris HW (2014) A prospective, randomized controlled trial of single-incision laparoscopic vs conventional 3-port laparoscopic appendectomy for treatment of acute appendicitis. J Am Coll Surg 218:950–959

    Article  PubMed  Google Scholar 

  11. Frutos MD, Abrisqueta J, Lujan J, Abellan I, Parrilla P (2013) Randomized prospective study to compare laparoscopic appendectomy versus umbilical single-incision appendectomy. Ann Surg 257:413–418

    Article  PubMed  Google Scholar 

  12. St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, Murphy JP, Andrews WS, Sharp RJ, Snyder CL, Holcomb GW III, Ostlie DJ (2011) Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg 254:586–590

    Article  PubMed  Google Scholar 

  13. Cho MS, Min BS, Hong YK, Lee WJ (2011) Single-site versus conventional laparoscopic appendectomy: comparison of short-term operative outcomes. Surg Endosc 25:36–40

    Article  PubMed  Google Scholar 

  14. Park J, Kwak H, Kim SG, Lee S (2012) Single-port laparoscopic appendectomy: comparison with conventional laparoscopic appendectomy. J Laparoendosc Adv Surg Tech A 22:142–145

    Article  PubMed  Google Scholar 

  15. Raakow R, Jacob DA (2011) Initial experience in laparoscopic single-port appendectomy: a pilot study. Dig Surg 28:74–79

    Article  PubMed  Google Scholar 

  16. Teoh AY, Chiu PW, Wong TC, Wong SK, Lai PB, Ng EK (2011) A case-controlled comparison of single-site access versus conventional three-port laparoscopic appendectomy. Surg Endosc 25:1415–1419

    Article  PubMed  Google Scholar 

  17. Autorino R, Kaouk JH, Stolzenburg JU, Gill IS, Mottrie A, Tewari A, Cadeddu JA (2013) Current status and future directions of robotic single-site surgery: a systematic review. Eur Urol 63:266–280

    Article  PubMed  Google Scholar 

  18. Lee JS, Choi YI, Lim SH, Hong TH (2012) Transumbilical single port laparoscopic appendectomy using basic equipment: a comparison with the three ports method. J Korean Surg Soc 83:212–217

    Article  PubMed  PubMed Central  Google Scholar 

  19. Sozutek A, Colak T, Dirlik M, Ocal K, Turkmenoglu O, Dag A (2013) A prospective randomized comparison of single-port laparoscopic procedure with open and standard 3-port laparoscopic procedures in the treatment of acute appendicitis. Surg Laparosc Endosc Percutan Tech 23:74–78

    Article  PubMed  Google Scholar 

  20. Lee WS, Choi ST, Lee JN, Kim KK, Park YH, Lee WK, Baek JH, Lee TH (2013) Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg 257:214–218

    Article  PubMed  Google Scholar 

  21. Teoh AY, Chiu PW, Wong TC, Poon MC, Wong SK, Leong HT, Lai PB, Ng EK (2012) A double-blinded randomized controlled trial of laparoendoscopic single-site access versus conventional 3-port appendectomy. Ann Surg 256:909–914

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 153, Gyo-dong, Chuncheon, 200-704, Korea

    Byung Mo Kang, Ji Woong Hwang & Byoung Yoon Ryu

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  1. Byung Mo Kang
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Correspondence to Byoung Yoon Ryu.

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Byung Mo Kang, Ji Woong Hwang and Byoung Yoon Ryu have no conflicts of interest or financial ties to disclose.

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Kang, B.M., Hwang, J.W. & Ryu, B.Y. Single-port laparoscopic surgery in acute appendicitis: retrospective comparative analysis for 618 patients. Surg Endosc 30, 4968–4975 (2016). https://doi.org/10.1007/s00464-016-4840-y

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  • DOI: https://doi.org/10.1007/s00464-016-4840-y

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