Single-port laparoscopic appendectomy: comparison with conventional laparoscopic appendectomy.

BACKGROUND: Laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. Since it was first described, laparoscopic appendectomy has been modified various times for reducing pain and improving cosmetic results. Single-port laparoscopic appendectomy (SPLA) may reduce more postoperative trauma and obtain reliable cosmetic results. We compared the safety and feasibility of this technique with those of conventional laparoscopic appendectomy (CLA).

SUBJECTS AND METHODS: Between November 2008 and July 2009, 104 patients were enrolled in this study. Their diagnoses were performed by computed tomography scan. The demographic findings and surgical outcomes such as operation time, pathology, postoperative pain score, hospital stay, and complications of the SPLA group were analyzed and compared with those of the CLA group.

RESULTS: SPLA was completed in 42 patients, and 62 patients underwent CLA. Mean age was 29.9 years in the CLA group and 23.9 years in the SPLA group. The average body mass index of patients was 23.0 kg/m(2) in the CLA group and 20.5 kg/m(2) in the SPLA group. Mean operation time was 55.8 minutes in the CLA group and 51.7 minutes in the SPLA group. There was no conversion to open appendectomy in both groups. No major complications were encountered in the two groups. The mean postoperative hospital stay was 2.9 days for the CLA group and 2.6 days for the SPLA group. There were no deaths in either group.

CONCLUSION: SPLA is a safe technique and shows excellent cosmetic results. This is an easy procedure for an experienced laparoscopic surgeon even with conventional laparoscopic instruments. It remains to be evaluated in cases of perforated appendicitis and periappendiceal abscess.