Feasibility of single-port laparoscopic appendectomy for retrocecal appendicitis: A propensity score-matched study with multi-port laparoscopic appendectomy

Table 1 Patients’ characteristics

	Pre-match				Post-match
	SPLA (n = 264)	MPLA (n = 777)	P value	SMD	SPLA (n = 235)	MPLA (n = 235)	P value	SMD
Age (year)a	29.3 ± 18.5	38.0 ± 20.8	< 0.001	0.444	31.1 ± 18.7	30.3 ± 18.7	0.646	0.044
Sex			0.523	0.051			0.854	0.026
Male	134 (50.8)	414 (53.3)			122 (51.9)	119 (50.6)
Female	130 (49.2)	363 (46.7)			113 (48.1)	116 (49.4)
BMI (kg/m²)b	22.3 ± 4.3	22.8 ± 4.0	0.038	0.138	22.4 ± 4.1	22.3 ± 4.3	0.567	0.038
Medical historyb			0.041	0.152			0.923	0.018
No	176 (66.7)	461 (59.3)			153 (65.1)	151 (64.3)
Yes	88 (33.3)	316 (40.7)			82 (34.9)	84 (35.7)
Abdominal operation history			0.288	0.087			1.000	0.015
No	244 (92.4)	699 (90.0)			215 (91.5)	214 (91.1)
Yes	20 (7.6)	78 (10.0)			20 (8.5)	21 (8.9)
Smoking			0.105	0.056			0.830	0.016
No	226 (85.6)	630 (81.1)			198 (84.3)	195 (83.0)
Yes	33 (12.5)	112 (14.4)			32 (13.6)	33 (14.0)
Quit	5 (1.9)	35 (4.5)			5 (2.1)	7 (3.0)
ASA classificationa			< 0.001	0.199			0.385	0.079
1	119 (45.1)	455 (58.6)			119 (50.6)	131 (55.7)
2	139 (52.7)	296 (38.1)			112 (47.7)	98 (41.7)
3	6 (2.3)	25 (3.2)			4 (1.7)	6 (2.6)
4	0 (0.0)	1 (0.1)			0 (0.0)	0 (0.0)
Pre-op WBC count (× 10³)	13.0 ± 4.1	12.7 ± 4.3	0.676	0.056	12.9 ± 4.1	12.7 ± 4.2	0.744	0.030
Pre-op CRPb	2.9 ± 4.8	3.7 ± 5.9	0.030	0.147	3.1 ± 5.0	3.1 ± 5.3	0.794	0.005
Type of appendicitisa			< 0.001	0.394			1.000	0.011
Mild	218 (82.6)	510 (65.6)			190 (80.9)	189 (80.4)
Severe	46 (17.4)	267 (34.4)			45 (19.1)	46 (19.6)
Presence of abscess			0.791	0.035			0.285	0.132
No	258 (97.7)	755 (97.2)			229 (97.4)	233 (99.1)
Yes	6 (2.3)	22 (2.8)			6 (2.6)	2 (0.9)
Pre-op PCD insertion			0.443	0.050			1.000	0.092
No	263 (99.6)	776 (99.9)			234 (99.6)	235 (100.0)
Yes	1 (0.4)	1 (0.1)			1 (0.4)	0 (0.0)

^aP < 0.001 vs multi-port laparoscopic appendectomy.

^bP < 0.05 vs multi-port laparoscopic appendectomy.

Data are shown as n (%) of patients or mean (SD). SPLA: Single-port laparoscopic appendectomy; MPLA: Multi-port laparoscopic appendectomy; BMI: Body mass index; SMD: Standardized mean difference; ASA: American Society of Anesthesiologists; WBC: White blood cell; CRP: C-reactive protein.

Table 2 Postoperative outcomes

	SPLA (n = 235)		MPLA (n = 235)		P value
		95%CI		95%CI
Operation time (minute)a	43.8 ± 15.8	(41.8, 45.9)	51.6 ± 18.7	(49.2, 54.0)	< 0.001
EBL (mL)b	6.5 ± 7.8	(5.4, 7.5)	8.6 ± 8.3	(7.5, 9.6)	< 0.001
Drain insertion					0.115
No	231 (98.3)		224 (95.3)
Yes	4 (1.7)		11 (4.7)
Complication					0.315
No	202 (86.0)		214 (91.1)
Ileus	2 (0.9)		1 (0.4)
Wound complication	24 (10.2)		18 (7.7)
Intra-abdominal abscess	6 (2.6)		2 (0.9)
Others	1 (0.4)		0 (0.0)
Postoperative pain score	3.2 ± 1.3	(3.1, 3.4)	3.1 ± 1.3	(3.0, 3.3)	0.178
Antibiotics					0.635
No	2 (0.9)		2 (0.9)
Cephalosporin	191 (81.3)		181 (77.0)
Cephalosporin + Metronidazole	41 (17.4)		50 (21.3)
Others	1 (0.4)		2 (0.9)
Hospital day (days)	2.7 ± 1.3	(2.6, 2.9)	2.9 ± 1.3	(2.7, 3.1)	0.176
Readmission					1.000
No	234 (99.6)		234 (99.6)
Yes	1 (0.4)		1 (0.4)

^aP < 0.001 vs multi-port laparoscopic appendectomy (operation time).

^bP < 0.05 vs multi-port laparoscopic appendectomy (estimated blood loss).

Data are shown as n (%) of patients or mean (SD). EBL: Estimated blood loss; SPLA: Single-port laparoscopic appendectomy; MPLA: Multi-port laparoscopic appendectomy.

Table 3 Multivariable regression analysis for the independent effect of number of surgical port on postoperative outcomes (for continuous variables)

Postoperative outcomes	Estimate (β/OR)	Standard error	95%CI	P value
Operation time (min, β)a	7.97	1.53	(4.97, 10.97)	< 0.001
EBL (mL, β)b	2.35	0.71	(0.96, 3.74)	0.001
Postoperative pain score (β)	-0.12	0.12	(-0.35, 0.12)	0.311
Hospital day (days, β)	0.16	0.10	(-0.04, 0.36)	0.123
Complication rate (%, OR)	1.80	0.30	(1.00, 3.32)	0.052
JP drain insertion (%, OR)c	0.06	1.07	(0.01, 0.39)	0.010

^aP < 0.001.

^bP = 0.001.

^cP = 0.010.

β: Beta coefficient; OR: Odds ratio; EBL: Estimated blood loss; JP: Jackson-Pratt drain.