Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jul 27, 2025; 17(7): 105925
Published online Jul 27, 2025. doi: 10.4240/wjgs.v17.i7.105925
Feasibility of single-port laparoscopic appendectomy for retrocecal appendicitis: A propensity score-matched study with multi-port laparoscopic appendectomy
Sang-Ah Woo, Seung Jae Roh, Nak Song Sung, Won Jun Choi
Sang-Ah Woo, Seung Jae Roh, Nak Song Sung, Won Jun Choi, Department of Surgery, Konyang University Hospital, Daejeon 35365, South Korea
Author contributions: Roh SJ conceived and designed the study; Woo SA participated in data collection, statistical analysis, and interpretation of the data and wrote the original draft; Roh SJ reviewed and participated in the critical revision of the manuscript; Sung NS and Choi WJ reviewed the manuscript; All the authors have read and approved the final manuscript.
Institutional review board statement: This retrospective chart review involving human participants was conducted in accordance with the ethical standards of the Institutional and National Research Committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Human Investigation Committee of the Konyang University Hospital (IRB, 2023-05-018).
Informed consent statement: The requirement for informed consent was waived due to the retrospective nature of the study.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
STROBE statement: The authors have read the STROBE Statement—checklist, and the manuscript was prepared and revised accordingly.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Seung Jae Roh, MD, Assistant Professor, Department of Surgery, Konyang University Hospital, 158, Gwanjeodong-ro, Seo-gu, Daejeon 35365, South Korea. rohsj2@kyuh.ac.kr
Received: February 11, 2025
Revised: March 31, 2025
Accepted: May 26, 2025
Published online: July 27, 2025
Processing time: 163 Days and 4.8 Hours
Abstract
BACKGROUND

Retrocecal appendicitis, the most common anatomical type, presents diagnostic and surgical challenges. Single-port laparoscopic appendectomy (SPLA) has been proposed as an alternative to multi-port laparoscopic appendectomy (MPLA) with advancements in minimally invasive surgery. However, few studies have compared the perioperative outcomes between the SPLA and MPLA for retrocecal appendicitis.

AIM

To compare the efficacy and safety between the SPLA and MPLA in treating retrocecal appendicitis, focusing on perioperative outcomes.

METHODS

This retrospective study analyzed data from 1041 patients who underwent SPLA or MPLA at Konyang University Hospital between October 2011 and February 2023. Propensity score matching (PSM) was used to minimize selection bias, resulting in 235 patients in each group. Additionally, non-inferiority tests, post-hoc analysis, and multivariable regression analysis were performed to validate the results and assess factors affecting postoperative outcomes.

RESULTS

After PSM, SPLA showed shorter operation time (43.8 ± 15.8 minutes vs 51.6 ± 18.7 minutes; P < 0.001) and lower estimated blood loss (EBL, 6.5 ± 7.8 mL vs 8.6 ± 8.3 mL; P < 0.001) than MPLA. No significant differences were observed in complications, pain scores, or length of hospital stay. SPLA was not inferior to MPLA in the main outcomes, except for the complication rate, where statistical power was insufficient. Multivariable regression confirmed SPLA as an independent factor for operation time and EBL.

CONCLUSION

SPLA is more feasible than MPLA for retrocecal appendicitis, offering advantages in operation time and estimated blood loss. This study supports SPLA as a viable alternative that enhances postoperative recovery.

Keywords: Retrocecal appendicitis; Laparoscopic appendectomy; Single-port laparoscopic appendectomy; Multi-port laparoscopic appendectomy; Propensity score matching

Core Tip: This study compared the efficacy and safety between the single-port laparoscopic appendectomy (SPLA) and multi-port laparoscopic appendectomy (MPLA) for retrocecal appendicitis, focusing on perioperative outcomes. After propensity score matching, SPLA was associated with a shorter operation time and lower estimated blood loss. No significant differences were observed in the other perioperative outcomes. Therefore, this study supports the feasibility of SPLA compared with MPLA for retrocecal appendicitis, suggesting that SPLA may be a viable alternative for improving postoperative recovery.