title: Single-incision versus conventional laparoscopic appendectomy in 688 patients: a retrospective comparative analysis.
abstract: BACKGROUND
  Laparoscopic surgery has become the standard for treating appendicitis. The cosmetic benefits of using single-incision laparoscopy are well known, but its duration, complications and time to recovery have not been well documented. We compared 2 laparoscopic approaches for treating appendicitis and evaluated postoperative pain, complications and time to full recovery.
  
  
  METHODS
  We retrospectively reviewed the cases of consecutive patients with appendicitis and compared those who underwent conventional laparoscopic appendectomy (CLA) performed using 3 incisions and those who underwent single-incision laparoscopic appendectomy (SILA). During SILA, the single port was prepared to increase visibility of the operative site.
  
  
  RESULTS
  Our analysis included 688 consecutive patients: 618 who underwent CLA and 70 who underwent SILA. Postsurgical complications occurred more frequently in the CLA than the SILA group (18.1% v. 7.1%, p = 0.018). Patients who underwent SILA returned to oral feeding sooner than those who underwent CLA (median 12 h v. 22 h, p < 0.001). These between-group differences remained significant after controlling for other factors. Direct comparison of only nonperforated cases, which was determined by pathological examination, revealed that SILA was significantly longer than CLA (60 min v. 50 min, p < 0.001). Patients who underwent SILA had longer in-hospital stays than those who underwent CLA (72 v. 55 h, p < 0.001); however, they had significantly fewer complications (3.0% v. 14.4%, p = 0.006).
  
  
  CONCLUSIONS
  In addition to its cosmetic advantages, SILA led to rapid recovery and no increase in postsurgical pain or complications.
authors.affiliation: The Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hung-Hua
authors.initials: HH
authors.lastname: Liang
authors.affiliation: The Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chin-Sheng
authors.initials: CS
authors.lastname: Hung
authors.affiliation: The Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei Medical University, Taipei, Taiwan.
authors.forename: Weu
authors.initials: W
authors.lastname: Wang
authors.affiliation: The Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ka-Wai
authors.initials: KW
authors.lastname: Tam
authors.affiliation: The Division of Gastroenterology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Chun-Chao
authors.initials: CC
authors.lastname: Chang
authors.affiliation: The Graduate Institute of Public Health, College of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hui-Hsiung
authors.initials: HH
authors.lastname: Liu
authors.affiliation: The Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei Medical University, Taipei, Taiwan.
authors.forename: Ko-Li
authors.initials: KL
authors.lastname: Yen
authors.affiliation: The Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei Medical University, Taipei, Taiwan.
authors.forename: Po-Li
authors.initials: PL
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult