medwireNews: Appendectomy performed via a single transumbilical port is associated with the same low risk for postoperative complications as conventional laparoscopic appendectomy, Spanish study results suggest.
In a group of 184 patients, early complications, namely wound hematoma and vomiting, occurred at the same rate of 4% among those who had single-port (n=91) and conventional laparoscopic appendectomy (n=93).
Only one late complication was seen, involving one patient who experienced wound swelling after single-port appendectomy.
Patients who had the single-port approach reported lower levels of postoperative pain than those who had conventional appendectomy.
Ma Frutos (Hospital Universitario Virgen de la Arrixaca, Murcia) and co-authors say that they believe "this approach will motivate surgeons, the industry, and academic centers to explore the possibilities and perfect the technology, and also determine as objectively as possible the degree of satisfaction and cosmetic advantages involved with this technique."
The findings, which appear in the Annals of Surgery, arise from the analysis of postoperative outcomes of acute appendicitis patients with a mean age of 30 years. All were randomly allocated to undergo transumbilical single-port or conventional laparascopic appendectomy.
At 9-12 hours postsurgery, mean pain score, measured on a scale of 1 to 10, where 1 equaled no pain and 10 equaled maximum pain, was 2.76 and 3.78 in the single-port and conventional groups, respectively.
Mean hospital stay after surgery was 18.9 hours in the single-port and 21.3 hours in the conventional appendectomy groups, which was a nonsignificant difference.
The single-port approach took significantly longer than the conventional approach, with respective mean operating times of 38.13 and 32.12 minutes.
Frutos et al say that key advantages of the single-port approach include a scar-free outcome and the complete avoidance of the epigastric vessel damage that can sometimes occur with use of the conventional laparoscopic approach. In the current study, this occurred in one patient, and led to emergency reoperation.
The authors conclude: "The transumbilical single-port approach is a feasible and safe technique for performing appendectomy… [that] represents a possible alternative to conventional laparoscopic appendectomy."
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