Single-incision laparoscopic appendectomy vs conventional laparoscopic appendectomy: Systematic review and meta-analysis

Table 1 Search strategies

Databases	Period of search	Search strategies
The Cochrane Library	Through January 30, 2013	(1) MeSH descriptor Appendectomy, Laparoscopic explode all trees
		(2) (laparoscop* or coelioscop* or celioscop* or peritoneoscop*) and appendectom*
		(3) 1 or 2
		(4) “single incision” or “single port” or “single site” or “one port” or “one incision” or “one site”
		(5) 3 and 4
MEDLINE (Pubmed)	Through January 30, 2013	(1) Appendectomy, laparoscopic [MeSH]
		(2) (laparoscop* or coelioscop* or celioscop* or peritoneoscop*) and appendectom*
		(3) 1 or 2
		(4) “single incision” or “single port” or “single site” or “one port” or “one incision” or “one site”
		(5) (randomised controlled trial [pt] or controlled clinical trial [pt] or randomised [tiab] or placebo [tiab] or drug therapy [sh] or randomly [tiab] or trial [tiab] or groups [tiab]) not (animals [mh] not humans [mh])
		(6) 3 and 4 and 5
EMBASE (OvidSP)	Through January 30, 2013	(1) (appendectomy.af.) or ( exp appendectomy/)
		(2) ((laparoscop* or coelioscop* or celioscop* or peritoneoscop*).af.) or ( exp Laparoscopy/)
		(3) (single incision or single port or single site or one port or one incision or one site).af.
		(4) (random* or factorial* or crossover* or placebo*).af.
		(5) expcrossoverprocedure/or exp double-blind procedure/or exp randomized controlled trial/or single-blind procedure/
		(6) 4 or 5
		(7) 1 and 2 and 3 and 6
Science Citation Index Expanded	Through January 30, 2013	(1) TS = (appendectom*)
		(2) TS = (laparoscop* or coelioscop* or celioscop* or peritoneoscop*)
		(3) TS = (“single incision” or “single port” or “single site” or “one port” or “one incision” or “one site”)
		(4) TS = (random* or blind* or placebo* or meta-analysis)
		(5) 1 and 2 and 3 and 4
CBM	Through January 30, 2013	Search strategy in was performed in Chinese. Includes search terms similar to the terms used in MEDLINE

MEDLINE: Medical Literature Analysis and Retrieval System Online; EMBASE: Excerpta Medica Database; CBM: Chinese Biomedical Literature Database; MeSH: Medical Subject Heading.

Table 2 Study characteristics

Study	Area	Study design	Participants (SILA/CLA)	Mean age, yr (SILA/CLA)	Male:female ratio (SILA/CLA)
Teoh et al[12]	Hong Kong	Multi-center	195 (98/97)	39.2/40.7	58:40/59:38
Lee et al[13]	South Korea	Single-center	229 (116/113)	28.4/28.5	64:52/68:45
Perez et al[14]	United States	Single-center	50 (25/25)	8.7/8.9	10:15/15:10
St Peter et al[15]	United States	Single-center	360 (180/180)	11.1/11.1	99:81/92:88
Sozutek et al[16]	Turkey	Single-center	50 (25/25)	30.6/30.0	12:13/7:18
Frutos et al[17]	Spain	Single-center	184 (91/93)	28.0/31.0	42:49/47:46

SILA: Single-incision laparoscopic appendectomy; CLA: Conventional laparoscopic appendectomy.

Table 3 Risk of bias assessment

Study	Sequence generation	Allocation concealment	Blinding of participants and personnel	Blinding of outcome assessment	Incomplete outcome data	Selective reporting
Teoh et al[12]	Low risk	Low risk	Low risk	Low risk	Low risk	Low risk
Lee et al[13]	Low risk	Uncertain	High risk	High risk	Uncertain	Low risk
Perez et al[14]	Low risk	Low risk	Low risk	Low risk	Uncertain	High risk
St Peter et al[15]	Low risk	Low risk	Low risk	High risk	Low risk	Low risk
Sozutek et al[16]	Low risk	Uncertain	High risk	High risk	Uncertain	High risk
Frutos et al[17]	Low risk	Uncertain	High risk	High risk	Low risk	High risk