title: Meta-analysis of randomized trials on single-incision laparoscopic versus conventional laparoscopic appendectomy.
abstract: BACKGROUND
  Single-incision laparoscopic appendectomy has emerged as a less invasive alternative to conventional laparoscopic surgery. High-quality relevant evidence is limited.
  
  
  METHODS
  A systematic review of electronic information sources was undertaken, with the objective of identifying randomized trials that compared single-incision with conventional laparoscopic appendectomy. Outcome measures included 30-day morbidity, abdominal abscess, wound infection, open conversion, reoperation, operative time, length of hospital stay, and postoperative pain. Fixed-effects and random-effects models were used to calculate combined overall effect sizes of pooled data. Data are presented as odds ratios or weighted mean differences with 95% confidence intervals (CIs).
  
  
  RESULTS
  Five randomized trials were identified, with a total of 746 patients. Thirty-day morbidity (9.6% vs 8.6%; odds ratio, 1.14; 95% CI, .69 to 1.89) and wound infection rates were similar between single-incision and conventional laparoscopy (4.0% vs 4.8%; odds ratio, .83; 95% CI, .41 to 1.68), whereas the duration of surgery was longer in the single-incision group (46.3 vs 40.7 minutes; weighted mean difference, 6.01; 95% CI, 2.26 to 9.76). Available data were not adequately robust to reach conclusions regarding the remaining outcome measures.
  
  
  CONCLUSIONS
  Similar postoperative morbidity and wound infection rates for single-incision and conventional laparoscopic appendectomy are supported by the current literature, but single-incision surgery requires longer operative time.
authors.affiliation: Center for Minimally Invasive Surgery, Neuwerk Hospital, Mönchengladbach, Germany; Department of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece. Electronic address: stavros.antoniou@hotmail.com.
authors.forename: Stavros A
authors.initials: SA
authors.lastname: Antoniou
authors.affiliation: Department of General and Visceral Surgery, Hospital of Linz, Linz, Austria.
authors.forename: Oliver O
authors.initials: OO
authors.lastname: Koch
authors.affiliation: Department of Vascular Surgery, Hellenic Red Cross Hospital, Athens, Greece.
authors.forename: George A
authors.initials: GA
authors.lastname: Antoniou
authors.affiliation: Department of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Lasithiotakis
authors.affiliation: Department of General Surgery, University Hospital of Heraklion, University of Crete, Heraklion, Greece.
authors.forename: George E
authors.initials: GE
authors.lastname: Chalkiadakis
authors.affiliation: Department of General and Visceral Surgery, Hospital Zell am See, Zell am See, Austria.
authors.forename: Rudolph
authors.initials: R
authors.lastname: Pointner
authors.affiliation: Center for Minimally Invasive Surgery, Neuwerk Hospital, Mönchengladbach, Germany.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Granderath
mesh_terms: D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Appendectomy; Laparoscopy; SILS; Single-access; Single-incision; Single-port