Meta-analysis of Prospective Randomized Studies Comparing Single-Incision Laparoscopic Cholecystectomy (SILC) and Conventional Multiport Laparoscopic Cholecystectomy (CMLC)

作者：Pisanu Adolfo^*; Reccia Isabella; Porceddu Giulia; Uccheddu Alessandro

来源：Journal of Gastrointestinal Surgery, 2012, 16(9): 1790-1801.

DOI：10.1007/s11605-012-1956-9

• Single-incision laparoscopic cholecystectomy
• SILC
• Single-incision laparoscopic surgery
• SILS
• Single-port access
• SPA
• Laparoendoscopic single site
• LESS
• Cholecystectomy
• Laparoscopy

Single-incision laparoscopic cholecystectomy (SILC) has gained acceptance among surgeons as there is a trend to minimize the invasiveness of laparoscopy. The aim of this meta-analysis has been to assess the feasibility and safety of SILC when compared to conventional multiport laparoscopic cholecystectomy (CMLC). %26lt;br%26gt;A literature search for trials comparing SILC and CMLC was performed. Studies were reviewed for the outcomes of interest: patient characteristics; operative time and conversion rate; postoperative pain; length of hospital stay; postoperative complications; and patient satisfactory score (0-10). Standardized mean difference (SMD) was calculated for continuous variables and odds ratio for qualitative variables. %26lt;br%26gt;Twelve prospective randomized trials comparing SILC and CMLC were analyzed. Overall, 892 patients were randomized to either SILC (465) or CMLC (427). Operative time was significantly longer in SILC (63.0 vs. 45.8 min, SMD = 1.004, 95% CI = 0.434-1.573). Patient satisfactory score significantly favored SILC (8.2 vs. 7.2, SMD = -0.759, 95% CI = -1.064 to -0.455). No other difference was found. %26lt;br%26gt;SILC is a safe and effective procedure for the treatment of uncomplicated benign gallbladder disease with a significant patient satisfaction. New multicenter randomized trials are expected to evaluate SILC in more complex circumstances such as acute cholecystitis, previous abdominal surgery, and severe obesity.

• 出版日期2012-9