Single-incision versus conventional laparoscopic appendicectomy in children: a systematic review and meta-analysis

Single-incision laparoscopic appendectomy (SILA) has been considered as an alternative to conventional laparoscopic appendectomy (CLA). The aim of this systematic review and meta-analysis was to compare clinical outcomes between single-incision laparoscopic appendicectomy and conventional laparoscopic appendicectomy in children. An electronic search of EMBASE, PubMed, MEDLINE was performed. Operative time, length of hospital stay, postoperative complications including wound infection, intra-abdominal infection, ileus in SILA and CLA were pooled and compared by meta-analysis. Twelve studies (4 randomized controlled trials, 1 prospective study and 7 retrospective studies) that included 2,109 pediatric patients were studied. Of these patients, 933 and 1,176 patients had undergone SILA and CLA, respectively. There was significant shorter length of hospital stay for SILA compared with CLA in children; however, pooling the results for SILA and CLA revealed no significant difference in operative time and postoperative complications. Compared with CLA, SILA has the advantage of shorter hospital stay. However, SILA failed to show any obvious advantages over CLA in operative time and postoperative complications including wound infection, intra-abdominal infection, and ileus.