Original Article

J Minim Invasive Surg 2016; 19(1): 19-24

Published online March 15, 2016

https://doi.org/10.7602/jmis.2016.19.1.19

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

Feasibility of Single Port Laparoscopic Surgery in Patients with Perforated Appendicitis

Byung Seo Choi, M.D., Geon Young Byun, M.D., Seong Bae Hwang, M.D., Sung Ryul Lee, M.D.

Department of Surgery, Damsoyu Hospital, Seoul, Korea

Correspondence to : Sung Ryul Lee
Department of Surgery, Damsoyu Hospital, 213, Bongeunsa-ro, Gangnam-gu, Seoul 06109, Korea
Tel: +82-2-542-2222 Fax: +82-2-542-0099
E-mail:Kingsoss@naver.com

Received: October 2, 2015; Revised: October 28, 2015; Accepted: November 2, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose: In recent years, single-port laparoscopic appendectomy (SPLA) has been gaining in popularity and there have been many reports on the results of SPLA. The purpose of this study is to investigate feasibility, safety, and cosmetic satisfaction with SPLA in treatment of perforated appendicitis. Methods: From September 2012 to March 2015, 227 patients underwent SPLA at Damsoyu hospital. The patients were divided into the simple and gangrenous appendicitis group (the S & G group) and the perforated appendicitis group (the P group). Operation time, hospital stay, drain insertion rate, surgical complication, and cosmetic satisfaction were evaluated. Results: A total of 227 patients consisted of 32 patients in the P group and 195 patients in the S & G group. There were no significant differences in the demographic data of the patients. The operation time and hospital stay were significantly longer in the P group (p=0.002 and p<0.0001, respectively). The rate of drain insertion was also higher in the P group (p=0.0002). However, no differences in postoperative complications (p=0.281) and cosmetic satisfaction (p=0.090) were observed between the two groups. Conclusion: SPLA for perforated appendicitis is a feasible, safe, and cosmetically acceptable procedure. However, longer operation time and hospital stay and higher drain insertion rate should be considered for patients undergoing SPLA for perforated appendicitis.

Keywords Laparoscopy, Single incision, Appendicitis

  1. Semm K. Endoscopic appendectomy. Endoscopy 1983;15:59-64.
    Pubmed CrossRef
  2. Chung RS, Rowland DY, Li P, Diaz J. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendec tomy. Am J Surg 1999;177:250-256.
    CrossRef
  3. Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a metaanalysis. J Am Coll Surg 1998;186:545-553.
    CrossRef
  4. Nguyen NT, Zainabadi K, Mavandadi S, et al. Trends in utilization and outcomes of laparoscopic versus open appendectomy. Am J Surg 2004;188:813-820.
    Pubmed CrossRef
  5. Gill RS, Shi X, Al-Adra DP, Birch DW, Karmali S. Singleincision appendectomy is comparable to conventional laparoscopic appendectomy: a systematic review and pooled analysis. Surg Laparosc Endosc Percutan Tech 2012;22:319-327.
    Pubmed CrossRef
  6. St Peter SD, Adibe OO, Juang D, et al. Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg 2011;254:586-590.
    Pubmed CrossRef
  7. Jeong SY. Single-incision laparoscopic appendectomy. J Korean Soc Coloproctol 2012;28:282-283.
    Pubmed KoreaMed CrossRef
  8. Brown CV, Abrishami M, Muller M, Velmahos GC. Appendiceal abscess: immediate operation or percutaneous drainage? Am Surg 2003;69:829-832.
    Pubmed
  9. Antonacci N, Ricci C, Taffurelli G, et al. Laparoscopic appendectomy: Which factors are predictors of conversion? A high-volume prospective cohort study. Int J Surg 2015.
    Pubmed CrossRef
  10. Kim JM, Lee SR, Kim HO. Comparison of clinical outcomes after laparoscopic and open appendectomy for complicated appendicitis. Journal of minimally invasive surgery 2013;16:98-103.
    CrossRef
  11. Markides G, Subar D, Riyad K. Laparoscopic versus open appendectomy in adults with complicated appendicitis: systematic review and meta-analysis. World J Surg 2010;34:2026-2040.
    Pubmed CrossRef
  12. Katsuno G, Nagakari K, Yoshikawa S, Sugiyama K, Fukunaga M. Laparoscopic appendectomy for complicated appendicitis: a comparison with open appendectomy. World J Surg 2009;33:208214.
    Pubmed CrossRef
  13. Dimitriou I, Reckmann B, Nephuth O, Betzler M. Single institution's experience in laparoscopic appendectomy as a suitable therapy for complicated appendicitis. Langenbecks Arch Surg 2013;398:147-152.
    Pubmed CrossRef
  14. Kang KC, Lee SY, Kang DB, et al. Application of single incision laparoscopic surgery for appendectomies in patients with complicated appendicitis. J Korean Soc Coloproctol 2010;26:388-394.
    Pubmed KoreaMed CrossRef
  15. Baik SM, Hong KS, Kim YI. A comparison of transumbilical single-port laparoscopic appendectomy and conventional threeport laparoscopic appendectomy: from the diagnosis to the hospital cost. J Korean Surg Soc 2013;85:68-74.
    Pubmed KoreaMed CrossRef
  16. Lee JS, Choi YI, Lim SH, Hong TH. Transumbilical single port laparoscopic appendectomy using basic equipment: a comparison with the three ports method. J Korean Surg Soc 2012;83:212-217.
    Pubmed KoreaMed CrossRef
  17. Kim H, Jung IM, Yun KW, et al. Early outcome of the Korean Diagnosis-Related Groups payment system for appendectomy. Ann Surg Treat Res 2015;88:126-132.
    Pubmed KoreaMed CrossRef
  18. Vilallonga R, Barbaros U, Nada A, et al. Single-port transumbilical laparoscopic appendectomy: a preliminary multicentric comparative study in 87 patients with acute appendicitis. Minim Invasive Surg 2012;2012:492409.
    CrossRef
  19. Lee JA, Sung KY, Lee JH, Lee dS. Laparoscopic appendectomy with a single incision in a single institute. J Korean Soc Coloproctol 2010;26:260-264.
    Pubmed KoreaMed CrossRef
  20. Warren J, Bhalla V, Cresci G. Postoperative diet advancement:surgical dogma vs. evidence-based medicine. Nutr Clin Pract 2011;26:115-125.
    Pubmed CrossRef
  21. Lee HS, Shim H, Jang JY, Lee H, Lee JG. Early feeding is feasible after emergency gastrointestinal surgery. Yonsei Med J 2014;55:395-400.
    Pubmed KoreaMed CrossRef
  22. Kuzma J. Randomized clinical trial to compare the length of hospital stay and morbidity for early feeding with opioid-sparing analgesia versus traditional care after open appendectomy. Clin Nutr 2008;27:694-699.
    Pubmed CrossRef
  23. Lee JM, Jang JY, Lee SH, Shim H, Lee JG. Feasibility of the short hospital stays after laparoscopic appendectomy for uncomplicated appendicitis. Yonsei Med J 2014;55:1606-1610.
    Pubmed KoreaMed CrossRef
  24. Lee WS, Choi ST, Lee JN, et al. Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg 2013;257:214218.
    Pubmed CrossRef

Article

Original Article

J Minim Invasive Surg 2016; 19(1): 19-24

Published online March 15, 2016 https://doi.org/10.7602/jmis.2016.19.1.19

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

Feasibility of Single Port Laparoscopic Surgery in Patients with Perforated Appendicitis

Byung Seo Choi, M.D., Geon Young Byun, M.D., Seong Bae Hwang, M.D., Sung Ryul Lee, M.D.

Department of Surgery, Damsoyu Hospital, Seoul, Korea

Correspondence to:Sung Ryul Lee
Department of Surgery, Damsoyu Hospital, 213, Bongeunsa-ro, Gangnam-gu, Seoul 06109, Korea
Tel: +82-2-542-2222 Fax: +82-2-542-0099
E-mail:Kingsoss@naver.com

Received: October 2, 2015; Revised: October 28, 2015; Accepted: November 2, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: In recent years, single-port laparoscopic appendectomy (SPLA) has been gaining in popularity and there have been many reports on the results of SPLA. The purpose of this study is to investigate feasibility, safety, and cosmetic satisfaction with SPLA in treatment of perforated appendicitis. Methods: From September 2012 to March 2015, 227 patients underwent SPLA at Damsoyu hospital. The patients were divided into the simple and gangrenous appendicitis group (the S & G group) and the perforated appendicitis group (the P group). Operation time, hospital stay, drain insertion rate, surgical complication, and cosmetic satisfaction were evaluated. Results: A total of 227 patients consisted of 32 patients in the P group and 195 patients in the S & G group. There were no significant differences in the demographic data of the patients. The operation time and hospital stay were significantly longer in the P group (p=0.002 and p<0.0001, respectively). The rate of drain insertion was also higher in the P group (p=0.0002). However, no differences in postoperative complications (p=0.281) and cosmetic satisfaction (p=0.090) were observed between the two groups. Conclusion: SPLA for perforated appendicitis is a feasible, safe, and cosmetically acceptable procedure. However, longer operation time and hospital stay and higher drain insertion rate should be considered for patients undergoing SPLA for perforated appendicitis.

Keywords: Laparoscopy, Single incision, Appendicitis

References

  1. Semm K. Endoscopic appendectomy. Endoscopy 1983;15:59-64.
    Pubmed CrossRef
  2. Chung RS, Rowland DY, Li P, Diaz J. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendec tomy. Am J Surg 1999;177:250-256.
    CrossRef
  3. Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a metaanalysis. J Am Coll Surg 1998;186:545-553.
    CrossRef
  4. Nguyen NT, Zainabadi K, Mavandadi S, et al. Trends in utilization and outcomes of laparoscopic versus open appendectomy. Am J Surg 2004;188:813-820.
    Pubmed CrossRef
  5. Gill RS, Shi X, Al-Adra DP, Birch DW, Karmali S. Singleincision appendectomy is comparable to conventional laparoscopic appendectomy: a systematic review and pooled analysis. Surg Laparosc Endosc Percutan Tech 2012;22:319-327.
    Pubmed CrossRef
  6. St Peter SD, Adibe OO, Juang D, et al. Single incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg 2011;254:586-590.
    Pubmed CrossRef
  7. Jeong SY. Single-incision laparoscopic appendectomy. J Korean Soc Coloproctol 2012;28:282-283.
    Pubmed KoreaMed CrossRef
  8. Brown CV, Abrishami M, Muller M, Velmahos GC. Appendiceal abscess: immediate operation or percutaneous drainage? Am Surg 2003;69:829-832.
    Pubmed
  9. Antonacci N, Ricci C, Taffurelli G, et al. Laparoscopic appendectomy: Which factors are predictors of conversion? A high-volume prospective cohort study. Int J Surg 2015.
    Pubmed CrossRef
  10. Kim JM, Lee SR, Kim HO. Comparison of clinical outcomes after laparoscopic and open appendectomy for complicated appendicitis. Journal of minimally invasive surgery 2013;16:98-103.
    CrossRef
  11. Markides G, Subar D, Riyad K. Laparoscopic versus open appendectomy in adults with complicated appendicitis: systematic review and meta-analysis. World J Surg 2010;34:2026-2040.
    Pubmed CrossRef
  12. Katsuno G, Nagakari K, Yoshikawa S, Sugiyama K, Fukunaga M. Laparoscopic appendectomy for complicated appendicitis: a comparison with open appendectomy. World J Surg 2009;33:208214.
    Pubmed CrossRef
  13. Dimitriou I, Reckmann B, Nephuth O, Betzler M. Single institution's experience in laparoscopic appendectomy as a suitable therapy for complicated appendicitis. Langenbecks Arch Surg 2013;398:147-152.
    Pubmed CrossRef
  14. Kang KC, Lee SY, Kang DB, et al. Application of single incision laparoscopic surgery for appendectomies in patients with complicated appendicitis. J Korean Soc Coloproctol 2010;26:388-394.
    Pubmed KoreaMed CrossRef
  15. Baik SM, Hong KS, Kim YI. A comparison of transumbilical single-port laparoscopic appendectomy and conventional threeport laparoscopic appendectomy: from the diagnosis to the hospital cost. J Korean Surg Soc 2013;85:68-74.
    Pubmed KoreaMed CrossRef
  16. Lee JS, Choi YI, Lim SH, Hong TH. Transumbilical single port laparoscopic appendectomy using basic equipment: a comparison with the three ports method. J Korean Surg Soc 2012;83:212-217.
    Pubmed KoreaMed CrossRef
  17. Kim H, Jung IM, Yun KW, et al. Early outcome of the Korean Diagnosis-Related Groups payment system for appendectomy. Ann Surg Treat Res 2015;88:126-132.
    Pubmed KoreaMed CrossRef
  18. Vilallonga R, Barbaros U, Nada A, et al. Single-port transumbilical laparoscopic appendectomy: a preliminary multicentric comparative study in 87 patients with acute appendicitis. Minim Invasive Surg 2012;2012:492409.
    CrossRef
  19. Lee JA, Sung KY, Lee JH, Lee dS. Laparoscopic appendectomy with a single incision in a single institute. J Korean Soc Coloproctol 2010;26:260-264.
    Pubmed KoreaMed CrossRef
  20. Warren J, Bhalla V, Cresci G. Postoperative diet advancement:surgical dogma vs. evidence-based medicine. Nutr Clin Pract 2011;26:115-125.
    Pubmed CrossRef
  21. Lee HS, Shim H, Jang JY, Lee H, Lee JG. Early feeding is feasible after emergency gastrointestinal surgery. Yonsei Med J 2014;55:395-400.
    Pubmed KoreaMed CrossRef
  22. Kuzma J. Randomized clinical trial to compare the length of hospital stay and morbidity for early feeding with opioid-sparing analgesia versus traditional care after open appendectomy. Clin Nutr 2008;27:694-699.
    Pubmed CrossRef
  23. Lee JM, Jang JY, Lee SH, Shim H, Lee JG. Feasibility of the short hospital stays after laparoscopic appendectomy for uncomplicated appendicitis. Yonsei Med J 2014;55:1606-1610.
    Pubmed KoreaMed CrossRef
  24. Lee WS, Choi ST, Lee JN, et al. Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg 2013;257:214218.
    Pubmed CrossRef

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