Comparison of the clinical effects among single-incision laparoscopic appendectomy, laparoscopic appendectomy and open appendectomy in elderly patients with acute appendicitis

Objective To compare the clinical effects among single-incision laparoscopic appendectomy(SILA), laparoscopic appendectomy(LA)and open appendectomy(OA)in the treatment of elderly patients with acute appendicitis. Methods A total of 98 consecutive elderly patients undergoing appendectomy in our hospital from November 2014 to December 2016 were retrospectively selected.Among them, 31 patients underwent SILA, 35 underwent LA and 32 underwent OA.The operation time, the first exhaust time after operation, length of hospital stay, Numerical Rating Scale(NRS)pain score, wound infection rate and incidence of postoperative complications were compared between the three groups. Results The postoperative venting time and length of hospital stay were shorter, NRS was less, wound infection rate and incidence of postoperative complications were lower in the SILA and LA groups than in the OA group[(21.5±5.2) h, (22.1±5.4) h vs.(24.8±5.8) h, (4.5±1.3) d, (4.8±1.4) d vs.(9.4±1.5) d, (3.7±0.5), (4.1±0.7) vs. (6.3±0.9), 0%, 0% vs. 12.5%, 9.7% or 3/31, 14.3% or 5/35 vs. 43.8% or 14/32, respectively, P<0.05), while the operative time was less in the LA and OA groups than in the SILA group(45.4±10.5) min, (48.6±1.4) min vs.(73.2±12.3)min, P<0.05). The incision NRS pain score was lower in the SILA group than in the LA and OA groups(3.7±0.5 in SILA vs.4.1±0.7 in LA vs. 6.3±0.9 in OA, P<0.05). Conclusions LA has advantages of less trauma, less pain, quicker recovery, fewer complications and beautiful incisions.SILA has less pain than LA, but needs longer operative time.SILA is worthy of promotion in the treatment of acute appendicitis especially in the elderly, but still needs further improvement. Key words: Appendicitis; Laparoscope; Appendectomy