title: Single incision versus conventional multiport laparoscopic appendectomy: a systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  The efficacy of single incision laparoscopic appendectomy (SILA) in comparison with conventional multiport laparoscopic appendectomy (CMLA) has not been conclusively determined.
  
  
  METHODS
  A systematic literature review (Medline, EMBASE, Science Citation Index, and Cochrane Central Register of Controlled Trials) was performed. Meta-analyses of randomized controlled trials (RCTs) comparing SILA with CMLA were carried out by RevMan 5.0 software.
  
  
  RESULTS
  Eleven RCTs comparing SILA and CMLA were included. Overall, 1,216 patients were operated on: 611 cases by SILA versus 605 cases by CMLA. Compared with CMLA, SILA was associated with increased procedural difficulty, prolonged procedural duration, shorter length of hospital stay, earlier return to normal activity and better cosmesis. There were no significant differences in postoperative pain scores and complication rates between SILA and CMLA.
  
  
  CONCLUSIONS
  The current best evidence shows SILA holds the promise of improving postoperative recovery and cosmetic result with equal efficacy and safety, whereas it is associated with higher surgical difficulty with longer surgical time when compared with CMLA.
authors.affiliation: Department of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, PR China.
authors.forename: Haiyang
authors.initials: H
authors.lastname: Zhou
authors.forename: Kaizhou
authors.initials: K
authors.lastname: Jin
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.forename: Weijun
authors.initials: W
authors.lastname: Wang
authors.forename: Yanping
authors.initials: Y
authors.lastname: Sun
authors.forename: Canping
authors.initials: C
authors.lastname: Ruan
authors.forename: Zhiqian
authors.initials: Z
authors.lastname: Hu
mesh_terms: D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome