Pain after single-incision versus conventional laparoscopic appendectomy: a propensity-matched analysis

• Published in: The Journal of surgical research Vol. 212; pp. 122 - 129
• Main Authors: Choi, Geun Joo, MD, PhD, Kang, Hyun, MD, PhD, Kim, Beom Gyu, MD, PhD, Choi, Yoo Shin, MD, PhD, Kim, Jin Yun, MD, PhD, Lee, Sangseok, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.05.2017
• Subjects: Acute appendicitis; Adult; Aged; Analgesia, Patient-Controlled; Appendectomy - methods; Appendicitis - surgery; Conventional laparoscopic appendectomy; Female; Humans; Laparoscopy - methods; Male; Middle Aged; Pain, Postoperative - drug therapy; Pain, Postoperative - prevention & control; Postoperative pain; Propensity Score; Propensity score matching; Retrospective Studies; Single-incision laparoscopic appendectomy; Surgery; Treatment Outcome; Propensity score matching; Acute appendicitis; Conventional laparoscopic appendectomy; Postoperative pain; Single-incision laparoscopic appendectomy
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2017.01.023

Abstract Background The aim of this study was to compare postoperative pain outcomes between single-incision laparoscopic appendectomy (SILA) and conventional laparoscopic appendectomy (CLA) using a propensity score matching analysis. Materials and methods Adult patients who underwent SILA or CLA for acute appendicitis between January 2010 and December 2015 at a single center were identified retrospectively from a prospectively collected database. All patients had used an intravenous patient-controlled analgesia (PCA) device for postoperative pain control. As potential confounding variables, patient characteristics and surgery-related, anesthesia-related, and PCA-related factors were collected from the database. The primary outcome was the postoperative pain score, and secondary outcomes were nausea, vomiting, rescue analgesic use, rescue antiemetic use, and PCA-related complications. These outcomes were compared between the SILA and CLA groups before and after 1:1 propensity score matching. Results From a total of 915 patients, 753 were selected: 116 in the SILA group and 637 in the CLA group. After propensity score matching, two comparable groups with 111 patients each were obtained. Pain score ( P  = 0.007) and rescue analgesic use ( P  = 0.043) on the day of surgery were significantly lower in the SILA group than in the CLA group. The other outcomes were similar between the two groups. Conclusions SILA is a beneficial surgical procedure for postoperative pain management.