TITLE:
Outcomes of Single-Incision Laparoscopic Appendectomy at a Single Center
AUTHORS:
Takahiro Watanabe, Hidetosi Wada, Masanori Sato, Yuichirou Miyaki, Junpei Tochikubo, Norihiko Shiiya
KEYWORDS:
Laparoscopic Appendectomy; Single Access Laparoscopic Surgery; Minimally Invasive Surgery
JOURNAL NAME:
Surgical Science,
Vol.4 No.10,
October
14,
2013
ABSTRACT: Background and Objectives: Recently, single-incision laparoscopic surgery has been popular for
minimally invasive surgery and cosmetic improvement. We studied outcomes of
single-incision laparoscopic appendectomy (SILA) in accordance with our
strategy for acute appendicitis. Methods: Clinical outcomes were revealed in each of nine emergency SILA (e-SILA) cases and
eight interval SILA (i-SILA) cases performed for the treatment of acute
appendicitis between September 2010 and August 2012 at our hospital. Results: The male to female ratio was
6:3 for e-SILA and 5:3 for i-SILA cases. Mean ages were 33.1 ± 17.8 years and
41 ± 21.6 years for e-SILA and i-SILA, respectively. The pretreatment white
blood cell (WBC) count and C-reactive protein (CRP) levels were 14960 ± 4080/μL
and 1.4 ± 2.3 mg/d, respectively, for e-SILA and 12657 ± 4290/μL and 6.7 ± 8.3
mg/d, respectively, for i-SILA. The maximum transverse diameter of appendix was
12.6 ± 3.5 mm for e-SILA and 11.6 ± 3.5 mm for i-SILA. Appendiceal abscesses
were encountered in one (11%) e-SILA and three (38%) i-SILA cases. Perforation
of the appendix at operation occurred in two (22%) e-SILA cases and no i-SILA
cases. Generalized peritonitis occurred in 4 (44%) e-SILA cases but in none
of the i-SILA cases. The postoperative hospital stay was 5.3 days for e-SILA,
2.7 days for i-SILA. Conversion to laparotomy was not required in either group.
One additional trocar was needed for an e-SILA case, and paralytic ileus
occurred as a postoperative complication in one e-SILA case. Conclusion: The outcomes of SILA
performed under our strategy were acceptable and useful without major
postoperative complications.