title: Comparison between single-incision and conventional three-port laparoscopic appendectomy: a meta-analysis from eight RCTs.
abstract: OBJECTIVE
  To assess the efficacy and safety of single-incision laparoscopic appendectomy (SILA), we conducted a meta-analysis of randomized controlled trials (RCTs) comparing conventional three-port laparoscopic appendectomy (CTLA).
  
  
  METHODS
  RCTs comparing the effects of SILA and CTLA were searched for in PubMed, the Cochrane Central Register of Controlled Trials, and Embase. Operative time, the pain visual analogue scales scores (VAS scores), dose of analgesics, postoperative complications, hospital charges, and duration of postoperative hospitalization in SILA and CTLA were pooled and compared by meta-analysis. Odds ratios and weighted mean differences (WMDs) were calculated with 95% confidence intervals (CIs) to evaluate the effect of SILA.
  
  
  RESULTS
  Eight original RCTs investigating 760 adults and 684 children, 1,444 patients in total, of whom 721 received SILA only and 723 received CTLA only, met the inclusion criteria. Both in adults and children, the mean operative time was significantly longer in SILA than CTLA (WMD5.45, 95% CI 2.15 to 8.75, p = 0.01). Compared with CTLA, in children, SILA have higher analgesic consumption (WMD 0.69, 95% CI 0.08 to 1.3, p = 0.03) and greater hospital charges (WMD 0.87, 95% CI 1.26 to 1.48, p = 0.005), which was not statistically different in adults (p > 0.05). Pooling the results for SILA and CTLA revealed no significant difference in VAS scores, wound infection rate, overall complications, and postoperative hospital stay.
  
  
  CONCLUSIONS
  SILA failed to show any obvious advantages over CTLA in perioperative and postoperative outcomes. Therefore, it represents a possible alternative to conventional three-port laparoscopic appendectomy.
authors.affiliation: Department of Gastrointestinal Surgery, Subei People's Hospital of Jiangsu Province (Clinical Medical College of Yangzhou University), 98 Nantong West Road, Yangzhou, Jiangsu Province, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Gao
authors.forename: Ping
authors.initials: P
authors.lastname: Li
authors.forename: Qingguo
authors.initials: Q
authors.lastname: Li
authors.forename: Dong
authors.initials: D
authors.lastname: Tang
authors.forename: Dao-Rong
authors.initials: DR
authors.lastname: Wang
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D001062:Appendectomy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D002648:Child; D017722:Hospital Charges; D006801:Humans; D007430:Intraoperative Care; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics; D007902:Length of Stay; D010147:Pain Measurement; D011182:Postoperative Care; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000700:Analgesics