Single‐incision versus conventional three‐incision laparoscopic appendectomy: A meta‐analysis of randomized controlled trials

Deng, Lihui; Xiong, Junjie; Xia, Qing

doi:10.1111/jebm.12238

Cited by 24 publications

(17 citation statements)

References 46 publications

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“…SLA showed a higher conversion rate than MLA in a recent meta-analysis [12]. In this study, contrarily, no open conversion was detected in the TULAA group, except one case of ileocecal resection for IA.…”

Section: Discussionmentioning

confidence: 41%

“…SLA is a potentially effective alternative to MLA, requiring only a small incision within the umbilical dimpling that was almost invisible postoperatively. However, previous studies, which compared SLA and MLA in adults showed a significantly longer operative time in SLA [7,8,9,10,11,12]. Technical difficulty might explain the longer operative time during the intracorporeal excision of the appendix in SLA.…”

Section: Discussionmentioning

confidence: 91%

“…Single-port laparoscopy has been proposed as an alternative to multi-port laparoscopy in a few surgical procedures, including appendectomy [3] and cholecystectomy [4], as well as for the management of colorectal neoplasm [5,6]. Previous studies compared single-port laparoscopic appendectomy (SLA) and multi-port laparoscopic appendectomy (MLA), and most of them concluded that SLA is not superior to MLA because SLA is associated with a longer operative time and yields similar cosmetic results [7,8,9,10,11,12].…”

Section: Introductionmentioning

confidence: 99%

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Transumbilical Single-Incision Laparoscopic-Assisted Appendectomy (TULAA) is Useful in Adults and Young Adolescents: Comparison with Multi-Port Laparoscopic Appendectomy

et al. 2019

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Background and objectives: Single-port laparoscopic appendectomy (SLA) in most previous studies has used intracorporeal excision of the appendix and needed a longer operative time than multi-port laparoscopic appendectomy (MLA), although SLA does have the potential benefit of an almost invisible scar within the umbilicus. Some studies have reported that extracorporeal transumbilical single-incision laparoscopic-assisted appendectomy (TULAA) in children took a considerably reduced operative time compared to MLA. We adopted TULAA in adults, adding routine dissection of the peritoneal attachment of the appendix. The aim was to compare the operative outcomes between TULAA and MLA. Materials and Methods: Between March 2013 and January 2016, 770 patients with acute uncomplicated and complicated appendicitis from 15 to 75 years of age were enrolled retrospectively. The operation was performed as early (EA) and interval appendectomy (IA). Results: Operative time was shorter in the TULAA group than in the MLA group, except for IA. No open conversion occurred in the TULAA group, except one case of ileocecal resection for IA. No intra-abdominal fluid collection was found in the TULAA group. Extended resection (especially partial cecectomy) was performed less frequently in the TULAA group than in the MLA group for IA. Mean postoperative hospital stay was shorter in the TULAA group for uncomplicated appendicitis. When the data of the EA group and the IA group were compared, operative time was significantly shorter in the IA group for both MLA and TULAA. The open conversion rate and the complication rate tended to be lower in the IA group. Confined to IA, the TULAA group tended to have shorter mean initial, postoperative, and total hospital stays. Conclusions: TULAA can be a useful surgical alternative to MLA in adults and young adolescents, because it lacks open conversion and provides both a shorter operative time and a shorter postoperative hospital stay. TULAA is feasible for IA in that it showed a lower rate of extended resection and complications.

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Section: Discussionmentioning

confidence: 41%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transumbilical Single-Incision Laparoscopic-Assisted Appendectomy (TULAA) is Useful in Adults and Young Adolescents: Comparison with Multi-Port Laparoscopic Appendectomy

et al. 2019

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“…Despite a lack of literature promoting this surgical approach across the pediatric population there are a few randomized studies that support single-incision techniques for appendectomy in both feasibility and safety compared to conventional laparoscopic surgery [42,43].…”

Section: Single Incision Laparoscopic and Thoracoscopic Surgerymentioning

confidence: 99%

Advances and Trends in Pediatric Minimally Invasive Surgery

Meinzer

Alkatout

Krebs

et al. 2020

JCM

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As many meta-analyses comparing pediatric minimally invasive to open surgery can be found in the literature, the aim of this review is to summarize the current state of minimally invasive pediatric surgery and specifically focus on the trends and developments which we expect in the upcoming years. Print and electronic databases were systematically searched for specific keywords, and cross-link searches with references found in the literature were added. Full-text articles were obtained, and eligibility criteria were applied independently. Pediatric minimally invasive surgery is a wide field, ranging from minimally invasive fetal surgery over microlaparoscopy in newborns to robotic surgery in adolescents. New techniques and devices, like natural orifice transluminal endoscopic surgery (NOTES), single-incision and endoscopic surgery, as well as the artificial uterus as a backup for surgery in preterm fetuses, all contribute to the development of less invasive procedures for children. In spite of all promising technical developments which will definitely change the way pediatric surgeons will perform minimally invasive procedures in the upcoming years, one must bear in mind that only hard data of prospective randomized controlled and double-blind trials can validate whether these techniques and devices really improve the surgical outcome of our patients.

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“…However, compared with the conventional laparoscopic procedure, there is currently no consensus on the superiority of the single-port procedure. Some studies have observed no significant difference between single-port and conventional laparoscopic procedures [11,12], while other studies have shown benefits of the single-port procedure over the conventional procedure [13,14]. Some studies even expressed concern about the difficulty and time consumption of the surgical procedure, which can be taxing on the surgeon [15,16].…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings

Kang

Cho²,

et al. 2020

Ann Coloproctol

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Original ArticleAnn Coloproctol 2020;36(1):17-21 https://doi.org/10. 3393/ac.2019.04.25 Purpose: Single-port laparoscopic techniques can be optimized with confined incisions. This approach has an intraoperative advantage of excellent visualization of the correct intestinal segment for exteriorization, along with direct visual control of the extraction to avoid twisting. However, only a few studies have verified the efficacy of the technique. Thus, this study assessed the results of single-port laparoscopic stoma creation for fecal diversion, specifically focusing on feasibility, safety, and efficacy. Methods: Patients who underwent single-incision enterostomy performed by a single surgeon were included. Data on demographics, indications for and chosen procedure, and operation results were retrospectively collected and analyzed. Results: Between April 2015 and January 2018, a total of 13 patients (8 males, 5 females) with a mean age of 57.7 years (range, 41-83 years) underwent single-port ileostomy creation. The most common reason for diversion was palliative ileostomy for colon obstruction or fistula from peritoneal malignancy (n = 12), followed by colonic fistula with necrotizing pancreatitis (n = 1). There were no cases of conversion to open or multiport laparoscopic surgery. The mean operative time was 54 minutes (range, 37-118 minutes), and the median length of hospital stay was 8 days (range, 2-211 days). A postoperative complication, aspiration pneumonia, was documented in 1 patient and treated conservatively. The mean duration of bowel movement was 0.7 days (range, 0-4 days). All stomas had good function, and there was no 30-day mortality. Conclusion: Single-port laparoscopic ileostomy in patients with a palliative setting could be a safe and feasible option for fecal diversion.

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Single‐incision versus conventional three‐incision laparoscopic appendectomy: A meta‐analysis of randomized controlled trials

Cited by 24 publications

References 46 publications

Transumbilical Single-Incision Laparoscopic-Assisted Appendectomy (TULAA) is Useful in Adults and Young Adolescents: Comparison with Multi-Port Laparoscopic Appendectomy

Transumbilical Single-Incision Laparoscopic-Assisted Appendectomy (TULAA) is Useful in Adults and Young Adolescents: Comparison with Multi-Port Laparoscopic Appendectomy

Advances and Trends in Pediatric Minimally Invasive Surgery

Safety and Efficacy of Single-Port Laparoscopic Ileostomy in Palliative Settings

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