title: Single-incision versus conventional three-incision laparoscopic appendectomy: A meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Conventional three-incision laparoscopic appendectomy (CTLA) is considered the new golden standard for the treatment of acute appendicitis. However, single-incision laparoscopic appendectomy (SILA) can further reduce the number of abdominal incisions and visible scars.
  
  
  METHODS
  Major databases were researched for randomized clinical trials (RCTs) comparing SILA and CTLA for acute appendicitis from January 1983 and to March 2015. The technical feasibility, effectiveness, and safety between SILA and CTLA were compared. Pooled odds ratios (ORs) and weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models.
  
  
  RESULTS
  In total, 11 RCTs with 1489 patients were analyzed. The patients in the SILA group had a significantly shorter hospital duration (WMD: -0.63; 95% CI: -1.04, -0.21; P = 0.003) and return to activity (WMD: -2.91; 95% CI: -5.45, -0.37; P = 0.02) but experienced a longer operating time (WMD: 6.56; 95% CI: 3.55, 9.58; P < 0.0001) and higher rate of conversion (OR: 6.82; 95% CI: 3.14, 14.79; P < 0.00001). There were no differences between the two groups in visual analog pain scores, doses of analgesics, overall complication rates, wound infection, or cosmesis (all P > 0.05).
  
  
  CONCLUSIONS
  SILA is a safer and more effective than CTLA in both pediatric and adult patients.
authors.affiliation: Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Lihui
authors.initials: L
authors.lastname: Deng
authors.affiliation: Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Xiong
authors.affiliation: Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Xia
mesh_terms: D000208:Acute Disease; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
keywords: Acute appendicitis; conventional three-incision laparoscopic appendectomy; single-incision laparoscopic appendectomy