title: Single-Incision Versus Three-Port Laparoscopic Appendectomy: Short- and Long-Term Outcomes.
abstract: OBJECTIVE
  To compare the outcome of patients who had undergone single-incision laparoscopic appendectomy (SILA) with others who had undergone three-port laparoscopic appendectomy (3-PORT).
  
  
  METHODS
  Data from all adults with uncomplicated appendicitis treated by laparoscopic appendectomy between June 2012 and December 2015 were prospectively collected. Patients with chronic pain, appendix malignancy, at least two previous laparotomies, and those undergoing concomitant surgery for different condition were excluded from analysis. Postoperative pain was assessed by a visual analog scale (VAS). Patients were reviewed postoperatively at 7 days and 1 month in the outpatient clinic. Late complications were assessed with a telephonic interview.
  
  
  RESULTS
  A total of 91 patients were included (46 SILA; 45 3-PORT). There were 16 males and 30 females in the SILA group (mean age = 26.76 ± 10.58 years) and 18 males and 27 females in the 3-PORT group (mean age = 26.84 ± 10.79 years). The mean operative time for SILA was 48.54 ± 12.80 min, for the 3-PORT group the mean operative time was 46.33 ± 15.54 min (P = 0.46). No case required conversion. Mean postoperative hospital length of stay was 1.87 ± 0.69 days for SILA and 2.38 ± 1.11 days for 3-PORT (P = 0.01). VAS value of 3.91 ± 1.96 and mean ketorolac usage of 0.38 ± 0.65 in 3-PORT group and SILA patients reported 3.70 ± 1.58 and 0.39 ± 0.58, respectively (P = 0.91). Our mean follow-up in SILA group was 25.75 ± 10.82 months, for 3-PORT group the mean follow-up was 26.9 ± 11.8 months. Eleven patients missed long-term follow-up. No incisional hernia was found. There is a statistically significant difference in cosmetic evaluation in favor of SILA (P < 0.005).
  
  
  CONCLUSIONS
  There was no difference in operative time, early complications, postoperative pain, analgesia requirement between SILA and 3-PORT laparoscopic appendectomy, but after SILA procedure discharge was quicker and long-term cosmetic satisfaction was superior.
authors.affiliation: 1 Department of Surgery and Translational Medicine, University of Florence , Florence, Italy .
authors.forename: Samatha
authors.initials: S
authors.lastname: Vellei
authors.affiliation: 2 Department of Emergency and Accident, Azienda Ospedaliera Universitaria Careggi (AOUC) , Florence, Italy .
authors.forename: Alessandro
authors.initials: A
authors.lastname: Borri
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D010351:Patient Discharge; D017060:Patient Satisfaction; D011183:Postoperative Complications; D055815:Young Adult
chemical_list: D000700:Analgesics
keywords: GI surgery; laparoscopic appendectomy; single surgery