Department of Gastrointestinal Surgery, Subei People's Hospital of Jiangsu Province (the First Affiliated Hospital of Yangzhou University), Yangzhou 225001, Jiangsu Province, China.
World J Gastroenterol. 2013 Jul 7;19(25):4072-82. doi: 10.3748/wjg.v19.i25.4072.
To compare single incision laparoscopic surgery for an appendectomy (SILS-A) with conventional laparoscopic appendectomy (C-LA) when implemented by experienced surgeons.
Studies and relevant literature regarding the performance of single-incision laparoscopic surgery vs conventional laparoscopic surgery for appendectomy were searched for in the Cochrane Central Register of Controlled Clinical Trials, MEDLINE, EMBASE and World Health Organization international trial register. The operation time (OR time), complications, wound infection and postoperative day using SILS-A or C-LA were pooled and compared using a meta-analysis. The risk ratios and mean differences were calculated with 95%CIs to evaluate the effect of SILS-A.
Sixteen recent studies including 1624 patients were included in this meta-analysis. These studies demonstrated that, compared with C-LA, SILS-A has a similar OR time in adults but needs a longer OR time in children. SILS-A has similar complications, wound infection and length of the postoperative day in adults and children, and required similar doses of narcotics in children, the pooled mean different of -0.14 [95%CI: -2.73-(-2.45), P > 0.05], the pooled mean different of 11.47 (95%CI: 10.84-12.09, P < 0.001), a pooled RR of 1.15 (95%CI: 0.72-1.83, P > 0.05), a pooled RR of 1.9 (95%CI: 0.92-3.91, P > 0.05), a pooled RR of 1.01 (95%CI: 0.51-2.0, P > 0.05) a pooled RR of 1.86 (95%CI: 0.77-4.48, P > 0.05), the pooled mean different of -0.25 (95%CI: -0.50-0, P = 0.05) the pooled mean different of -0.01 (95%CI: -0.05-0.04, P > 0.05) the pooled mean different of -0.13 (95%CI: -0.49-0.23, P > 0.05) respectively.
SILS-A is a technically feasible and reliable approach with short-term results similar to those obtained with the C-LA procedure.
比较经验丰富的外科医生实施单切口腹腔镜阑尾切除术（SILS-A）与传统腹腔镜阑尾切除术（C-LA）的效果。
检索 Cochrane 对照临床试验中心注册库、MEDLINE、EMBASE 和世界卫生组织国际临床试验注册平台，查找比较单切口腹腔镜阑尾切除术与传统腹腔镜阑尾切除术的相关研究及文献。采用荟萃分析汇总并比较 SILS-A 和 C-LA 的手术时间（OR 时间）、并发症、伤口感染和术后天数。采用风险比（RR）和均数差值（MD）及其 95%置信区间（CI）评估 SILS-A 的效果。
本荟萃分析纳入 16 项最新研究共 1624 例患者。结果显示，与 C-LA 相比，SILS-A 在成人中的 OR 时间相似，但在儿童中耗时更长。SILS-A 在成人和儿童中的并发症、伤口感染和术后天数相似，且儿童所需的麻醉药物剂量相似，MD 差值为-0.14（95%CI：-2.73 至-2.45，P>0.05），MD 差值为 11.47（95%CI：10.84 至 12.09，P<0.001），RR 为 1.15（95%CI：0.72 至 1.83，P>0.05），RR 为 1.9（95%CI：0.92 至 3.91，P>0.05），RR 为 1.01（95%CI：0.51 至 2.0，P>0.05），RR 为 1.86（95%CI：0.77 至 4.48，P>0.05），MD 差值为-0.25（95%CI：-0.50 至 0，P=0.05），MD 差值为-0.01（95%CI：-0.05 至 0.04，P>0.05），MD 差值为-0.13（95%CI：-0.49 至 0.23，P>0.05）。
SILS-A 是一种技术上可行且可靠的方法，其短期效果与 C-LA 相似。
