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Single-Incision Laparoscopic Cholecystectomy Versus Traditional Laparoscopic Cholecystectomy: A updated Meta-analysis of Randomized Controlled Trials
2017
1. Abstract 1.1. Objectives: To assess the clinical efficacy of Single-Incision
Laparoscopic Cholecystectomy (LESS) compared with Traditional Laparoscopic Cholecystectomy
(TLC) based on published literature. 1.2. Subjects and Methods: An online systematic search Randomized
Controlled Trials (RCTs) comparing LESS with TLC were included Pubmed, Embase and
the Cochrane Library. The inclusion and extraction of the data were completed
by two authors independently. Meta-analysis was performed using version Review
Manager 5.1.4 software. The clinical outcomes
measures were demographics, postoperative Visual Analog Scale pain score, operative
complication rate, intraoperative blood loss, cosmetic score, postoperative
hospital stay, operating time, wound length; operating time, quality of life
score was evaluated by Odds Ratio (OR) and Standard Mean Difference (SMD)
according to the different types of data. A meta-analysis of the outcomes was
conducted. 1.3. Results: Fifteen RCTs involving 1069 patients
met the predefined inclusion criteria. The cosmetic score of the LESS group was
statistically higher than that for TLC. (SMD, 0.55; 95 % CI, 0.20, 0.90; p =
0.002); the postoperative hospital stay of the LESS group was statistically
shorter than that for TLC. (SMD, -0.24; 95 % CI, -0.44, -0.04; p = 0.02); the
operating time of LESS groups was statistically longer than TLC. (SMD, 0.83; 95
% CI, 0.52, 1.14; p < 0.00001); the wound length of LESS was statistically
smaller than TLC. (SMD, -2.90; 95 % CI, - 4.22, -1.58; p < 0.0001); the
quality of life of LESS was statistically better than that for TLC. (SMD, 1.17;
95 % CI, 0.06, 2.28; p =0.04); There was no significant difference between the
two groups with Visual Analog Scale pain score, intraoperative blood loss,
perioperative complication rate. 1.4. Conclusion: LESS is associated with a higher
cosmetic score, shorter postoperative hospital stays, smaller wound length,
better short-term quality of life compared with TLC. 2. Keywords: Laparoscopic
Cholecystectomy; Meta-Analysis; Single-Incision; Traditional Laparoscopic
Cholecystectomy
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