A case-controlled comparison of single-site access versus conventional three-port laparoscopic appendectomy.
BACKGROUND
The aim of this study was to compare patients who underwent single-site access laparoscopic appendectomy (SSALA) to those who underwent conventional three-port laparoscopic appendectomy (TPLA) in a case-controlled manner.


METHODS
Consecutive patients who underwent SSALA for suspected acute appendicitis between April and September 2009 were retrospectively compared to those who underwent TPLA between January and December 2008 in a case-controlled manner. The patients were matched for age, gender, and pathological findings. The main outcome measurements included postoperative recovery, morbidities, and mortalities.


RESULTS
During the study period, a total of 30 patients underwent SSALA and these were matched with 60 TPLA patients. There were no significant differences in the mean operative time, hospital stay, and 30-day morbidity rate between the two groups. None of the patients required conversion. Two patients with significant contamination and abscess collection noted during SSALA required a relaparotomy for peritoneal lavage and adhesiolysis due to prolonged ileus.


CONCLUSIONS
SSALA is feasible and the perioperative outcome was comparable to that of TPLA. However, future prospective studies will need to evaluate whether SSALA can adequately tackle patients with significant peritoneal contamination.
Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, 30-32, Ngan Shing Street, Shatin, NT, Hong Kong.
Anthony Yuen Bun
AY
Teoh
Philip Wai Yan
PW
Chiu
Tiffany Cho Lam
TC
Wong
Simon Kin Hung
SK
Wong
Paul Bo San
PB
Lai
Enders Kwok Wai
EK
Ng
D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D011182:Postoperative Care; D011183:Postoperative Complications; D012086:Reoperation