title: Single-incision versus conventional three-port laparoscopic appendectomy: A meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  The aim of this article was to compare the advantages and disadvantages of single-incision laparoscopic appendectomy (SILA) and conventional three-port laparoscopic appendectomy (CTLA).
  
  
  METHODS
  A meta-analysis was performed by analyzing all randomized controlled trials (RCTs) published in English that compared SILA and CTLA for appendicitis in adults and children. These studies compared these two methods from different angles including outcomes of interest, patient characteristics, operative time, pain visual analogue scales scores (VAS scores), length of hospital stay, time to return to full activity, resumption of diet, postoperative complications and cosmetic results The risk ratios (RR) and mean difference (MD) with 95% confidence intervals (CIs) were employed to assess the outcome.
  
  
  RESULTS
  Seven recent RCTs encompassing 1170 patients (586 SILA and 584 CTLA cases) were included in this meta-analysis. The pooled results demonstrated that conversion rate, drain inserted, reoperation, length of hospital stay, resumption of normal diet and postoperative complications were statistically comparable between the two groups. The postoperative abdominal pain within 24 h was -0.57 in favor of the SILA technique (p = 0.05). Compared with CTLA, SILA showed a better cosmetic satisfaction score (SMD, 0.58; 95% CI, 0.32-0.83; p < 0.0001) and shorter time to recover normal activity (WMD, -0.69; 95% CI, -1.11-0.26; p = 0.001). However, SILA has a longer operative time (WMD, 5.38; 95% CI, 2.94-7.83; p < 0.0001).
  
  
  CONCLUSIONS
  In selected patients, SILA was confirmed to be as safe and effective as CTLA. Despite the longer operative time, SILA has higher cosmetic satisfaction and shorter recovery time to normal activity. Due to the limitations of the available data, further research is needed.
authors.affiliation: Department of surgery, The Second Affiliated Hospital of Anhui Medical University , Anhui , China.
authors.forename: Jiang-Ming
authors.initials: JM
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Geng
authors.forename: Sheng-Xue
authors.initials: SX
authors.lastname: Xie
authors.forename: Fu-Bao
authors.initials: FB
authors.lastname: Liu
authors.forename: Yi-Jun
authors.initials: YJ
authors.lastname: Zhao
authors.forename: Li-Quan
authors.initials: LQ
authors.lastname: Yu
authors.forename: Xiao-Ping
authors.initials: XP
authors.lastname: Geng
mesh_terms: D001062:Appendectomy / Q000379:methods*; D004954:Esthetics; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D061646:Operative Time; D059408:Pain Management; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function
keywords: Laparoscopic appendectomy; abdominal surgery; general surgery