Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy
Background: Single‐incision laparoscopic cholecystectomy (SILC) may offer advantages over conventional laparoscopic cholecystectomy (LC). Methods: MEDLINE, Embase, PubMed, CINAHL, Cochrane Central Register of Controlled Trials and the Cochrane Library were searched for randomized clinical trials on...
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| Veröffentlicht in: | British journal of surgery 2013-01, Vol.100 (2), p.191-208 |
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| creator | Trastulli, S. Cirocchi, R. Desiderio, J. Guarino, S. Santoro, A. Parisi, A. Noya, G. Boselli, C. |
| description | Background:
Single‐incision laparoscopic cholecystectomy (SILC) may offer advantages over conventional laparoscopic cholecystectomy (LC).
Methods:
MEDLINE, Embase, PubMed, CINAHL, Cochrane Central Register of Controlled Trials and the Cochrane Library were searched for randomized clinical trials on SILC versus LC until May 2012. Odds ratio (OR) and weight mean difference (WMD) were calculated with 95 per cent confidence intervals (c.i.) based on intention‐to‐treat analysis.
Results:
Thirteen randomized clinical trials included a total of 923 procedures. SILC had a higher procedure failure rate than LC (OR 8·16, 95 per cent c.i. 3·42 to 19·45; P < 0·001), required a longer operating time (WMD 16·55, 95 per cent c.i. 9·95 to 23·15 min; P < 0·001) and was associated with greater intraoperative blood loss (WMD 1·58, 95% of c.i. 0·44 to 2·71 ml; P = 0·007). There were no differences between the two approaches in rate of conversion to open surgery, length of hospital stay, postoperative pain, adverse events, wound infections or port‐site hernias. Better cosmetic outcomes were demonstrated in favour of SILC as measured by Body Image Scale questionnaire (WMD − 0·97, 95% of c.i. − 1·51 to − 0·43; P < 0·001) and Cosmesis score (WMD − 2·46, 95% of c.i. − 2·95 to − 1·97; P < 0·001), but this was based on comparison with procedures in which multiple and often large ports (10 mm) were used.
Conclusion:
SILC has a higher procedure failure rate with more blood loss and takes longer than LC. No trial was adequately powered to assess safety. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
No advantages for single incision |
| doi_str_mv | 10.1002/bjs.8937 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1239056985</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3963053631</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4847-c5116450e656cb41ac4911ff44fba93a1c4b3115eaf778aea2c60c60b106ef1c3</originalsourceid><addsrcrecordid>eNpd0d1qFDEUB_Agit1WwSeQgAjeTM2ZTJKZS622KotetOJlOJPNaNbMZE1mth2fwYc2Q9cWhJBA8svX_xDyDNgpMFa-brfptG64ekBWwKUoSpD1Q7JijKkCeMmPyHFKW8aAM1E-JkclBwllDSvy53JOo-1xdIZGu3f2muKwob0dscAB_ZxcoqGjMc-G3v22G2q8G5xBT8fo0CdqQr_D6IbvNOXO28INxiUXBrq3MU0LGPZ2GPNM3uQx45BM2OUbzY_grVleYMbQz0_Ioy6faJ8exhPy9fz91dmHYv3l4uPZm3VhqrpShREAshLMSiFNWwGaqgHouqrqWmw4gqlaDiAsdkrVaLE0kuXWApO2A8NPyKvbc3cx_JpsGnXvkrHe42DDlDSUvGFCNrXI9MV_dBummD-SlZKqUQKkzOr5QU1tbzd6F12Pcdb_cs7g5QFgytF1Oc6c0b2TCoCrMrvi1l07b-e7dWB6qbPOddZLnfXbT5fLeO9dzvDmzmP8qaXiSuhvny80NOzq3Zoxfc7_Aoa7q8E</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1767975166</pqid></control><display><type>article</type><title>Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><source>Oxford University Press Journals All Titles (1996-Current)</source><creator>Trastulli, S. ; Cirocchi, R. ; Desiderio, J. ; Guarino, S. ; Santoro, A. ; Parisi, A. ; Noya, G. ; Boselli, C.</creator><creatorcontrib>Trastulli, S. ; Cirocchi, R. ; Desiderio, J. ; Guarino, S. ; Santoro, A. ; Parisi, A. ; Noya, G. ; Boselli, C.</creatorcontrib><description>Background:
Single‐incision laparoscopic cholecystectomy (SILC) may offer advantages over conventional laparoscopic cholecystectomy (LC).
Methods:
MEDLINE, Embase, PubMed, CINAHL, Cochrane Central Register of Controlled Trials and the Cochrane Library were searched for randomized clinical trials on SILC versus LC until May 2012. Odds ratio (OR) and weight mean difference (WMD) were calculated with 95 per cent confidence intervals (c.i.) based on intention‐to‐treat analysis.
Results:
Thirteen randomized clinical trials included a total of 923 procedures. SILC had a higher procedure failure rate than LC (OR 8·16, 95 per cent c.i. 3·42 to 19·45; P < 0·001), required a longer operating time (WMD 16·55, 95 per cent c.i. 9·95 to 23·15 min; P < 0·001) and was associated with greater intraoperative blood loss (WMD 1·58, 95% of c.i. 0·44 to 2·71 ml; P = 0·007). There were no differences between the two approaches in rate of conversion to open surgery, length of hospital stay, postoperative pain, adverse events, wound infections or port‐site hernias. Better cosmetic outcomes were demonstrated in favour of SILC as measured by Body Image Scale questionnaire (WMD − 0·97, 95% of c.i. − 1·51 to − 0·43; P < 0·001) and Cosmesis score (WMD − 2·46, 95% of c.i. − 2·95 to − 1·97; P < 0·001), but this was based on comparison with procedures in which multiple and often large ports (10 mm) were used.
Conclusion:
SILC has a higher procedure failure rate with more blood loss and takes longer than LC. No trial was adequately powered to assess safety. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
No advantages for single incision</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.8937</identifier><identifier>PMID: 23161281</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Abdominal Pain - etiology ; Bias ; Biological and medical sciences ; Blood Loss, Surgical - statistics & numerical data ; Body Image ; Cholecystectomy, Laparoscopic - adverse effects ; Cholecystectomy, Laparoscopic - methods ; Conversion to Open Surgery - statistics & numerical data ; Gallbladder Diseases - surgery ; General aspects ; Hernia, Abdominal - etiology ; Humans ; Length of Stay ; Liver, biliary tract, pancreas, portal circulation, spleen ; Medical sciences ; Miscellaneous ; Operative Time ; Pain, Postoperative - etiology ; Patient Satisfaction ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Randomized Controlled Trials as Topic - methods ; Randomized Controlled Trials as Topic - standards ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Surgical Wound Infection - etiology ; Treatment Failure</subject><ispartof>British journal of surgery, 2013-01, Vol.100 (2), p.191-208</ispartof><rights>Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4847-c5116450e656cb41ac4911ff44fba93a1c4b3115eaf778aea2c60c60b106ef1c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fbjs.8937$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fbjs.8937$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,4024,27923,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26711372$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23161281$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Trastulli, S.</creatorcontrib><creatorcontrib>Cirocchi, R.</creatorcontrib><creatorcontrib>Desiderio, J.</creatorcontrib><creatorcontrib>Guarino, S.</creatorcontrib><creatorcontrib>Santoro, A.</creatorcontrib><creatorcontrib>Parisi, A.</creatorcontrib><creatorcontrib>Noya, G.</creatorcontrib><creatorcontrib>Boselli, C.</creatorcontrib><title>Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
Single‐incision laparoscopic cholecystectomy (SILC) may offer advantages over conventional laparoscopic cholecystectomy (LC).
Methods:
MEDLINE, Embase, PubMed, CINAHL, Cochrane Central Register of Controlled Trials and the Cochrane Library were searched for randomized clinical trials on SILC versus LC until May 2012. Odds ratio (OR) and weight mean difference (WMD) were calculated with 95 per cent confidence intervals (c.i.) based on intention‐to‐treat analysis.
Results:
Thirteen randomized clinical trials included a total of 923 procedures. SILC had a higher procedure failure rate than LC (OR 8·16, 95 per cent c.i. 3·42 to 19·45; P < 0·001), required a longer operating time (WMD 16·55, 95 per cent c.i. 9·95 to 23·15 min; P < 0·001) and was associated with greater intraoperative blood loss (WMD 1·58, 95% of c.i. 0·44 to 2·71 ml; P = 0·007). There were no differences between the two approaches in rate of conversion to open surgery, length of hospital stay, postoperative pain, adverse events, wound infections or port‐site hernias. Better cosmetic outcomes were demonstrated in favour of SILC as measured by Body Image Scale questionnaire (WMD − 0·97, 95% of c.i. − 1·51 to − 0·43; P < 0·001) and Cosmesis score (WMD − 2·46, 95% of c.i. − 2·95 to − 1·97; P < 0·001), but this was based on comparison with procedures in which multiple and often large ports (10 mm) were used.
Conclusion:
SILC has a higher procedure failure rate with more blood loss and takes longer than LC. No trial was adequately powered to assess safety. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
No advantages for single incision</description><subject>Abdominal Pain - etiology</subject><subject>Bias</subject><subject>Biological and medical sciences</subject><subject>Blood Loss, Surgical - statistics & numerical data</subject><subject>Body Image</subject><subject>Cholecystectomy, Laparoscopic - adverse effects</subject><subject>Cholecystectomy, Laparoscopic - methods</subject><subject>Conversion to Open Surgery - statistics & numerical data</subject><subject>Gallbladder Diseases - surgery</subject><subject>General aspects</subject><subject>Hernia, Abdominal - etiology</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Liver, biliary tract, pancreas, portal circulation, spleen</subject><subject>Medical sciences</subject><subject>Miscellaneous</subject><subject>Operative Time</subject><subject>Pain, Postoperative - etiology</subject><subject>Patient Satisfaction</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Randomized Controlled Trials as Topic - methods</subject><subject>Randomized Controlled Trials as Topic - standards</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Surgical Wound Infection - etiology</subject><subject>Treatment Failure</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0d1qFDEUB_Agit1WwSeQgAjeTM2ZTJKZS622KotetOJlOJPNaNbMZE1mth2fwYc2Q9cWhJBA8svX_xDyDNgpMFa-brfptG64ekBWwKUoSpD1Q7JijKkCeMmPyHFKW8aAM1E-JkclBwllDSvy53JOo-1xdIZGu3f2muKwob0dscAB_ZxcoqGjMc-G3v22G2q8G5xBT8fo0CdqQr_D6IbvNOXO28INxiUXBrq3MU0LGPZ2GPNM3uQx45BM2OUbzY_grVleYMbQz0_Ioy6faJ8exhPy9fz91dmHYv3l4uPZm3VhqrpShREAshLMSiFNWwGaqgHouqrqWmw4gqlaDiAsdkrVaLE0kuXWApO2A8NPyKvbc3cx_JpsGnXvkrHe42DDlDSUvGFCNrXI9MV_dBummD-SlZKqUQKkzOr5QU1tbzd6F12Pcdb_cs7g5QFgytF1Oc6c0b2TCoCrMrvi1l07b-e7dWB6qbPOddZLnfXbT5fLeO9dzvDmzmP8qaXiSuhvny80NOzq3Zoxfc7_Aoa7q8E</recordid><startdate>201301</startdate><enddate>201301</enddate><creator>Trastulli, S.</creator><creator>Cirocchi, R.</creator><creator>Desiderio, J.</creator><creator>Guarino, S.</creator><creator>Santoro, A.</creator><creator>Parisi, A.</creator><creator>Noya, G.</creator><creator>Boselli, C.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201301</creationdate><title>Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy</title><author>Trastulli, S. ; Cirocchi, R. ; Desiderio, J. ; Guarino, S. ; Santoro, A. ; Parisi, A. ; Noya, G. ; Boselli, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4847-c5116450e656cb41ac4911ff44fba93a1c4b3115eaf778aea2c60c60b106ef1c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Abdominal Pain - etiology</topic><topic>Bias</topic><topic>Biological and medical sciences</topic><topic>Blood Loss, Surgical - statistics & numerical data</topic><topic>Body Image</topic><topic>Cholecystectomy, Laparoscopic - adverse effects</topic><topic>Cholecystectomy, Laparoscopic - methods</topic><topic>Conversion to Open Surgery - statistics & numerical data</topic><topic>Gallbladder Diseases - surgery</topic><topic>General aspects</topic><topic>Hernia, Abdominal - etiology</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Liver, biliary tract, pancreas, portal circulation, spleen</topic><topic>Medical sciences</topic><topic>Miscellaneous</topic><topic>Operative Time</topic><topic>Pain, Postoperative - etiology</topic><topic>Patient Satisfaction</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Randomized Controlled Trials as Topic - methods</topic><topic>Randomized Controlled Trials as Topic - standards</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Surgical Wound Infection - etiology</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Trastulli, S.</creatorcontrib><creatorcontrib>Cirocchi, R.</creatorcontrib><creatorcontrib>Desiderio, J.</creatorcontrib><creatorcontrib>Guarino, S.</creatorcontrib><creatorcontrib>Santoro, A.</creatorcontrib><creatorcontrib>Parisi, A.</creatorcontrib><creatorcontrib>Noya, G.</creatorcontrib><creatorcontrib>Boselli, C.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Trastulli, S.</au><au>Cirocchi, R.</au><au>Desiderio, J.</au><au>Guarino, S.</au><au>Santoro, A.</au><au>Parisi, A.</au><au>Noya, G.</au><au>Boselli, C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2013-01</date><risdate>2013</risdate><volume>100</volume><issue>2</issue><spage>191</spage><epage>208</epage><pages>191-208</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
Single‐incision laparoscopic cholecystectomy (SILC) may offer advantages over conventional laparoscopic cholecystectomy (LC).
Methods:
MEDLINE, Embase, PubMed, CINAHL, Cochrane Central Register of Controlled Trials and the Cochrane Library were searched for randomized clinical trials on SILC versus LC until May 2012. Odds ratio (OR) and weight mean difference (WMD) were calculated with 95 per cent confidence intervals (c.i.) based on intention‐to‐treat analysis.
Results:
Thirteen randomized clinical trials included a total of 923 procedures. SILC had a higher procedure failure rate than LC (OR 8·16, 95 per cent c.i. 3·42 to 19·45; P < 0·001), required a longer operating time (WMD 16·55, 95 per cent c.i. 9·95 to 23·15 min; P < 0·001) and was associated with greater intraoperative blood loss (WMD 1·58, 95% of c.i. 0·44 to 2·71 ml; P = 0·007). There were no differences between the two approaches in rate of conversion to open surgery, length of hospital stay, postoperative pain, adverse events, wound infections or port‐site hernias. Better cosmetic outcomes were demonstrated in favour of SILC as measured by Body Image Scale questionnaire (WMD − 0·97, 95% of c.i. − 1·51 to − 0·43; P < 0·001) and Cosmesis score (WMD − 2·46, 95% of c.i. − 2·95 to − 1·97; P < 0·001), but this was based on comparison with procedures in which multiple and often large ports (10 mm) were used.
Conclusion:
SILC has a higher procedure failure rate with more blood loss and takes longer than LC. No trial was adequately powered to assess safety. Copyright © 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
No advantages for single incision</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>23161281</pmid><doi>10.1002/bjs.8937</doi><tpages>18</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | British journal of surgery, 2013-01, Vol.100 (2), p.191-208 |
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| source | MEDLINE; Access via Wiley Online Library; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Abdominal Pain - etiology Bias Biological and medical sciences Blood Loss, Surgical - statistics & numerical data Body Image Cholecystectomy, Laparoscopic - adverse effects Cholecystectomy, Laparoscopic - methods Conversion to Open Surgery - statistics & numerical data Gallbladder Diseases - surgery General aspects Hernia, Abdominal - etiology Humans Length of Stay Liver, biliary tract, pancreas, portal circulation, spleen Medical sciences Miscellaneous Operative Time Pain, Postoperative - etiology Patient Satisfaction Public health. Hygiene Public health. Hygiene-occupational medicine Randomized Controlled Trials as Topic - methods Randomized Controlled Trials as Topic - standards Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Surgical Wound Infection - etiology Treatment Failure |
| title | Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy |
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