Comparison of Single Port and Conventional Laparoscopic Surgery in Acute Appendicitis

Hong, Young Han; Sohn, Tae Jun; Oh, Sung Jin; Chang, Yeon Soo; Kang, Jae Hee; Kim, Dong Hee; Lee, Tae Seok; Han, Joon Kil

Abstract

PURPOSE
Laparoscopic surgery is widely applied for treating acute appendicitis, and even the complicated cases. Single port laparoscopic surgery has recently been introduced and it is being increasingly accepted for treating acute appendicitis. The aim of this study is to evaluate the effectiveness of single port laparoscopic appendectomy as compared with that of conventional laparoscopic surgery.
METHODS
Eighty-seven patients who underwent laparoscopic appendectomy were enrolled. The clinicopathologic characteristics, the perioperative courses and postoperative pain using the VAS (visual analog scale) were compared between the conventional (n=61) and single port (n=26) groups.
RESULTS
There were no significant differences in age (28.2 Vs. 32.4, respectively), gender (29:32 Vs. 13:13, respectively) and BMI (22.3 Vs. 22.0, respectively) between the two groups. An extraperitoneal location of the appendix was found in 10 cases (16.4%) of the conventional group and in 4 cases (15.4%) of the single port group. Statistically, no significant difference was shown in terms of the degree of inflammation of the appendicitis. The average length of the operation was significantly shorter in the single port group compared to that of the conventional group (52.4 Vs. 41.3 minutes, respectively, p<0.05). The VAS at 6 hours after surgery (5.2 Vs. 6.0, respectively) and at the time of discharge (1.9 Vs. 1.9, respectively) showed no differences between the two groups. There was no difference for the postoperative hospital stay (3.8 Vs. 3.1 days, respectively) and the rate of postoperative complications (16.4% Vs. 7.7%, respectively) between the two groups. Wound infection was the most common complication.
CONCLUSION
When regarding the minimal scar and invasiveness, single port laparoscopic appendectomy is feasible option for treating acute appendicitis. With accumulation of experiences and the development of instruments, additional studies are needed for the indications and advantages of single port surgery.