title: Single incision versus conventional multi-incision appendicectomy for suspected appendicitis.
abstract: BACKGROUND
  Appendicectomy is a well established surgical procedure used in the management of acute appendicitis.  The operation can be performed with minimally invasive surgery (laparoscopic) or as an open procedure. A recent development in appendicectomy has been the introduction of less invasive single incision laparoscopic surgery, using a single multi-luminal port or multiple mono-luminal ports, through a single skin incision. There are yet unanswered questions regarding the efficacy of this new and novel technique including: patient benefit and satisfaction, complications, long-term outcomes, and survival.
  
  
  OBJECTIVE
  The aim of this review is to perform meta-analysis using data from available trials comparing single incision with conventional multi-incision laparoscopic appendicectomy for appendicitis, in order to ascertain any differences in outcome.
  
  
  METHODS
  We searched the electronic databases including MEDLINE/PubMed (from 1980 to December 2010), EMBASE/Ovid (from 1980 to December 2010) and CENTRAL (The Cochrane Library 2010, Issue 11) with pre-specified terms. We also searched reference lists of relevant articles and reviews, conference proceedings and ongoing trial databases.
  
  
  METHODS
  Randomised or quasi-randomised controlled trials of patients with appendicitis, or symptoms of appendicitis, undergoing laparoscopic appendicectomy, in which at least one arm involves single incision procedures and another multi-incision procedures.
  
  
  METHODS
  There were no RCTs or prospectively controlled trials found that met the inclusion criteria.
  
  
  RESULTS
  Three authors performed study selection independently.No studies that met the inclusion criteria of this review were identified. Current evidence exists only the form of case-series.This review has been authored as 'empty' pending the results of 5 ongoing trials.
  
  
  CONCLUSIONS
  No RCTs comparing single incision laparoscopic appendectomy with multi-incision surgery could be identified. No definitive conclusions can be made at this time. Well designed prospective RCTs are required in order to evaluate benefit or harm from laparoscopic surgical approaches for appendicectomy. Until appropriate data has been reported, the institutional polices of healthcare providers must be based on the clinical judgement of experts in the field.
authors: General Surgery, University of Aberdeen, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, UK, AB25 2ZD.
authors: Haroon
authors: H
authors: Rehman
authors: Ahsan M
authors: AM
authors: Rao
authors: Irfan
authors: I
authors: Ahmed
mesh_terms: D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D006801:Humans