title: Single-incision versus conventional three-incision laparoscopic appendicectomy for appendicitis: a systematic review and meta-analysis.
abstract: BACKGROUND
  This meta-analysis was designed to investigate the safety and efficacy of single-incision laparoscopic appendicectomy (SILA) and three-incision laparoscopic appendicectomy (TILA) in the treatment of appendicitis.
  
  
  METHODS
  Studies published since 1992 that compared SILA versus TILA in laparoscopic appendicectomy were collected. Data on operative parameters, postoperative recovery, postoperative pain and complications, and hospitalization costs for SILA and TILA were meta-analyzed using fixed-effect and random-effect models.
  
  
  RESULTS
  Seventeen studies (1 randomized controlled trial and 16 retrospective studies) that included 1809 patients were studied. Of these patients, 793 and 1016 had undergone SILA and TILA, respectively. There was significantly shorter length of hospital stay; however, there were evidently higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs for SILA compared with TILA. Other outcome variables such as operative time, blood loss, time to first oral intake, postoperative pain and complications were not found to be statistically significant for either group.
  
  
  CONCLUSIONS
  Compared with TILA, SILA has the advantage of shorter hospital stay, and it can achieve comparable operative time, blood loss, postoperative recovery, postoperative pain and complications with TILA. The drawback is that SILA is associated with higher conversion rate, and perhaps higher surgical difficulty and hospitalization costs. Whether it can achieve improvement in cosmesis remains to be confirmed.
authors.affiliation: Department of Gastrointestinal Surgery, Guizhou Provincial people's Hospital, Guiyang, China. dingjieboy@126.com
authors.forename: Jie
authors.initials: J
authors.lastname: Ding
authors.forename: Yu
authors.initials: Y
authors.lastname: Xia
authors.forename: Zhong-min
authors.initials: ZM
authors.lastname: Zhang
authors.forename: Guo-qing
authors.initials: GQ
authors.lastname: Liao
authors.forename: Yang
authors.initials: Y
authors.lastname: Pan
authors.forename: Sheng
authors.initials: S
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Zhongshu
authors.initials: Z
authors.lastname: Yan
mesh_terms: D001062:Appendectomy / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D001064:Appendicitis / Q000191:economics / Q000601:surgery*; D016063:Blood Loss, Surgical; D003365:Costs and Cost Analysis; D004750:Enteral Nutrition; D004954:Esthetics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D007813:Laparotomy / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function