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Single Incision Laparoscopic Appendectomy for Management of Complicated Appendicitis: Comparison between Single-Incision and Conventional

  • Oh, Yoon Jung (Department of Surgery, Konyang University Hospital) ;
  • Sung, Nak Song (Department of Surgery, Konyang University Hospital) ;
  • Choi, Won Jun (Department of Surgery, Konyang University Hospital) ;
  • Yoon, Dae Sung (Department of Surgery, Konyang University Hospital) ;
  • Choi, In Seok (Department of Surgery, Konyang University Hospital) ;
  • Lee, Sang Eok (Department of Surgery, Konyang University Hospital) ;
  • Moon, Ju Ik (Department of Surgery, Konyang University Hospital) ;
  • Kwon, Seong Uk (Department of Surgery, Konyang University Hospital) ;
  • Park, Si Min (Department of Surgery, Konyang University Hospital) ;
  • Bae, In Eui (Department of Surgery, Konyang University Hospital)
  • Received : 2018.05.14
  • Accepted : 2018.06.26
  • Published : 2018.12.15

Abstract

Purpose: Single incision laparoscopic appendectomy (SILA) is a widely used surgical procedure for treatment of appendicitis with better cosmesis. However, many surgeons generally tend to choose conventional multiport laparoscopic appendectomy regarding with complicated appendicitis. The aim of this study is to demonstrate the safety and feasibility of SILA for treatment of complicated appendicitis by comparison with 3-ports conventional laparoscopic appendectomy (CLA). Methods: Retrospective chart review of patients diagnosed appendicitis at single hospital during January 2015 to May 2017 collected 500 patients. Among 134 patients with complicated appendicitis, we compared outcomes for 29 patients who got SILA and 105 patients who got CLA. Results: 179 and 321 patients were treated by SILA and CLA, respectively. 134 (26.8%) patients were treated for complicated appendicitis, 29 patients by SILA and 105 patients by CLA, respectively. There was no case converted to open or added additional trocar in both groups. There were no differences in demographics with regard to age, sex, body mass index (BMI), and American society of anesthesiologists (ASA) scores. There was no difference in mean operating time ($58.97{\pm}18.53$ (SILA) vs. $57.57{\pm}21.48$ (CLA), p=0.751). The drain insertion rate (6.9% vs 37.1%, p=0.001) and the length of hospital stay ($2.76{\pm}1.41$ vs. $3.97{\pm}2.97$, p=0.035) were lower in SILA group with significance. There was no significant difference in the rate of surgical site infection (6.9% vs. 6.7%, p=1.000). Conclusion: This study demonstrates that SILA is a feasible and safe procedure for treatment of complicated appendicitis.

Keywords

References

  1. Ohmann C, Franke C, Kraemer M, Yang Q. [Status report on epidemiology of acute appendicitis]. Chirurg 2002;73:769-776. https://doi.org/10.1007/s00104-002-0512-7
  2. Meljnikov I, Radojcic B, Grebeldinger S, Lucic-Prostran B, Radojcic N. [A history of appendicitis surgical treatment]. Vojnosanit Pregl 2009;66:845-850.
  3. Yu MC, Feng YJ, Wang W, Fan W, Cheng HT, Xu J. Is laparoscopic appendectomy feasible for complicated appendicitis? A systematic review and meta-analysis. Int J Surg 2017;40:187-19.7 https://doi.org/10.1016/j.ijsu.2017.03.022
  4. Aly OE, Black DH, Rehman H, Ahmed I. Single incision laparoscopic appendicectomy versus conventional three-port laparoscopic appendicectomy: A systematic review and meta-analysis. Int J Surg 2016;35:120-128. https://doi.org/10.1016/j.ijsu.2016.09.087
  5. Kim JH, Kim HY, Park SK, et al. Single-incision Laparoscopic Appendectomy Versus Conventional Laparoscopic Appendectomy: Experiences From 1208 Cases of Single-incision Laparoscopic Appendectomy. Ann Surg 2015;262:1054-1058. https://doi.org/10.1097/SLA.0000000000001064
  6. Wang X, Zhang W, Yang X, Shao J, Zhou X, Yuan J. Complicated appendicitis in children: is laparoscopic appendectomy appropriate? A comparative study with the open appendectomy--our experience. J Pediatr Surg 2009;44:1924-1927. https://doi.org/10.1016/j.jpedsurg.2009.03.037
  7. Yeh CC, Wu SC, Liao CC, Su LT, Hsieh CH, Li TC. Laparoscopic appendectomy for acute appendicitis is more favorable for patients with comorbidities, the elderly, and those with complicated appendicitis: a nationwide population-based study. Surg Endosc 2011;25:2932-2942. https://doi.org/10.1007/s00464-011-1645-x
  8. Donmez T, Hut A, Avaroglu H, et al. Two-port laparoscopic appendectomy assisted with needle grasper comparison with conventional laparoscopic appendectomy. Ann Surg Treat Res 2016;91:59-65. https://doi.org/10.4174/astr.2016.91.2.59
  9. Donmez T, Sunamak O, Ferahman S, Uludag SS, Yildirim D, Hut A. Two-port laparoscopic appendectomy with the help of a needle grasper: better cosmetic results and fewer trocars than conventional laparoscopic appendectomy. Wideochir Inne Tech Maloinwazyjne 2016;11:105-110.
  10. Wieck MM, Hamilton NA, Krishnaswami S. A cost and outcome analysis of pediatric single-incision appendectomy. J Surg Res 2016;203:253-257. https://doi.org/10.1016/j.jss.2016.04.033
  11. Litz CN, Farach SM, Danielson PD, Chandler NM. Obesity and single-incision laparoscopic appendectomy in children. J Surg Res 2016;203:283-286. https://doi.org/10.1016/j.jss.2016.03.039
  12. Zhao L, Liao Z, Feng S, Wu P, Chen G. Single-incision versus conventional laparoscopic appendicectomy in children: a systematic review and meta-analysis. Pediatr Surg Int 2015;31:347-35.3 https://doi.org/10.1007/s00383-015-3680-5
  13. Concha JA, Cartes-Velasquez R, Delgado CM. Single-incision laparoscopic appendectomy versus conventional laparoscopy in adults. A systematic review. Acta Cir Bras 2014;29:826-831. https://doi.org/10.1590/S0102-86502014001900010
  14. Markar SR, Karthikesalingam A, Di Franco F, Harris AM. Systematic review and meta-analysis of single-incision versus conventional multiport appendicectomy. Br J Surg 2013;100:1709-1718. https://doi.org/10.1002/bjs.9296