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Single‐incision versus conventional laparoscopic cholecystectomy: a meta‐analysis
Author(s) -
Wang Zhanhui,
Huang Xinyu,
Zheng Qi
Publication year - 2012
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2012.06284.x
Subject(s) - medicine , meta analysis , confidence interval , randomized controlled trial , laparoscopic cholecystectomy , surgery , cholecystectomy , adverse effect , odds ratio , patient satisfaction , blood loss , postoperative pain , anesthesia
Background Conventional laparoscopic cholecystectomy ( CL C ) is now accepted as the gold standard surgical treatment for gallbladder stone disease. Single‐incision laparoscopic technology has recently been introduced into laparoscopic clinical practice in order to reduce the invasiveness of this procedure. A meta‐analysis of randomized clinical trials ( RCT s ) was performed to compare single‐incision laparoscopic cholecystectomy ( SICL ) and CLC . Methods Medline, E mbase, ISI W eb of K nowledge CPCI ‐ S and the C ochrane L ibrary were searched and the methodological quality of the included trials was evaluated. Outcomes evaluated were adverse events, conversion rate, post‐operative hospital stay, blood loss, post‐operative pain, total wound length, operative time and wound satisfaction score. Results were pooled in meta‐analyses as odds ratio and weighted mean differences ( WMD ). Results Five RCTs on 264 patients qualified for the meta‐analysis, 139 being allocated to SILC and 125 to CLC . There was no significant difference between SICL and CLC for adverse events, conversion rate, post‐operative hospital stay, blood loss, post‐operative pain and total wound length; however, operative time was significantly longer in SICL than in CLC ( WMD 7.72 (95% confidence interval ( CI ): 1.38–14.07) min; P = 0.02, χ 2 P = 0.02, I 2 = 69%). Furthermore, wound satisfaction score was significantly higher in SICL than in CLC ( WMD 1.40 (95% CI : 1.19–1.61) min; P < 0.00001, χ 2 P = 0.19, I 2 = 42%). Conclusion SILC may be superior to CLC in terms of cosmetic outcome, but not in operative time. Currently, SILC is a safe procedure for proper patients in experienced surgeons.