MTP2.15 Single-Port vs Multi-Port Laparoscopic Appendectomy in Perforated Appendicitis: A Systematic Review

Single-port laparoscopic surgery (SPLS) is a promising alternative to multi-port laparoscopic surgery (MPLS) in emergency settings for emergency appendectomies, particularly in high-risk populations. This systematic review evaluates SPLS's safety, effectiveness, and recent advancements to inform clinical decisions and practice. A systematic search of PubMed, Embase, and Cochrane Library identified studies comparing SPLS with MPLS in emergency appendectomies. Outcomes assessed included conversion rates from laparoscopic to open surgery, operative time, postoperative complications, length of hospital stay, cosmetic outcomes, and patient satisfaction. The analysis adhered to PRISMA guidelines, employing a random-effects model for data synthesis. Operative times between SPLS and MPLS showed no significant difference (mean difference: 0.07 minutes, 95% CI: -8.51 to 8.64) but exhibited substantial heterogeneity (I² = 76%). Postoperative pain was significantly lower with SPLS (mean difference: -1.32, 95% CI: -1.43 to -1.21, p < 0.00001), with no heterogeneity (I² = 0%). Hospital stays were similar (mean difference: -0.58 days, 95% CI: -1.42 to 0.26). Cosmetic satisfaction was higher for SPLS (90–95%) compared to MPLS (72–80%). SPLS demonstrates significant advantages in pain reduction and cosmetic outcomes, with comparable operative times and hospital stays. SPLS offers significant advantages in cosmetic outcomes and pain alleviation, rendering it a feasible choice for emergency appendectomies in specific patient populations. The procedure's safety profile in high-risk groups is well-established; however, MPLS is still favoured in more critical situations due to its reduced conversion rates. Further research focusing on paediatric uses and ergonomic improvements are vital for enhancing SPLS's function in emergency settings.