title: Meta-analysis of studies comparing single-incision laparoscopic appendectomy and conventional multiport laparoscopic appendectomy.
abstract: BACKGROUND
  There is no consensus that single-incision laparoscopic appendectomy (SILS-A) is on a par with conventional multiport laparoscopic appendectomy (CMLA). The aim of this meta-analysis was to assess feasibility, safety, and potential benefits of SILS-A when compared with CMLA.
  
  
  METHODS
  A literature search for studies comparing SILS-A and CMLA was performed. Studies were reviewed for the outcome of interest: patient characteristics, operative outcome, postoperative recovery, postoperative morbidity, patient satisfaction, and cosmetic results.
  
  
  RESULTS
  Thirteen studies comparing SILS-A and CMLA were reviewed: two prospective randomized trials, four prospective studies, and seven retrospective studies. Overall, 893 patients were operated on: by SILS-A in 402 cases (45.0%) versus 491 cases (55.0%) by CMLA. Patients in the SILS-A group were significantly younger than those in the CMLA group (31.2 versus 33.5 y). No other differences were found. Patient satisfaction score was impossible to meta-analyze.
  
  
  CONCLUSIONS
  Appendectomy via SILS-A may be considered as an alternative to CMLA. However, these results must be approached with caution as they are based on data from nonrandomized observational studies. The feasibility and safety of SILS-A must be mainly assessed for difficult clinical situations such as severe obesity, localized abscess, or diffuse peritonitis from a ruptured appendix in the setting of new prospective randomized trials.
authors.affiliation: Department of Surgery, Clinica Chirurgica, University of Cagliari, Monserrato, Italy. adolfo.pisanu@unica.it
authors.forename: Adolfo
authors.initials: A
authors.lastname: Pisanu
authors.forename: Giulia
authors.initials: G
authors.lastname: Porceddu
authors.forename: Isabella
authors.initials: I
authors.lastname: Reccia
authors.forename: Alessandra
authors.initials: A
authors.lastname: Saba
authors.forename: Alessandro
authors.initials: A
authors.lastname: Uccheddu
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D017060:Patient Satisfaction; D011184:Postoperative Period; D016896:Treatment Outcome
keywords: Appendectomy; Laparoscopy; SILS-A; Single-incision laparoscopic surgery appendectomy