A Meta-analysis Of The Efficacy Of Single Vs Multi-port Laparoscopic Inguinal Hernioplasty

Objective: To systematically evaluate the safety and feasibility of single-port versus multi-port approach in laparoscopic inguinal hernia repair.Methods: We searched databases of Pub Med,The Cochrane Library,EMBASE,CNKI,VIP Chinese journals and Wan Fang Data to collect the clinical studies comparing single-port and multi-port approach in laparoscopic inguinal hernia repair.The retrieved studies were subjected to a set of inclusion and exclusion criteria.Then meta-analysis was performed using Rev Man 5.3 software.A P<0.05 was considered statistically significant.Results: A total of 7 RCTs about 702 patients were included,including 361 in the single-incision laparoscopic group(SILS)and 341 in the multi-incision laparoscopic group(MILS).Meta-analysis results showed that single-incision inguinal hernia repair was superior to multi-incision inguinal hernia repair in respect of postoperative cosmetic result [MD=-0.72,95% CI=-1.36~-0.08,P=0.03],while there was no significant difference between the two procedures in terms of operative time[ unilateral:MD=-1.29,95% CI=-6?02~ 3.44,P=0.59;bilateral:MD=-1.21,95% CI=-12.89~ 10.46,P=0.84],length of postoperative hospital stay[ MD=-0.01,95% CI=-0.06~ 0.05,P=0.81],pain score on postoperative 24 hours[MD=0.74,95% CI=-0.03~ 1.52,P=0.06],pain score on postoperative day 7[MD=0.65,95% CI=-0.77~ 2.06,P=0.37],postoperative recovery time[ MD=2.59,95% CI=-2.60~ 7.79,P=0.98 ],incidence of perioperative complications[OR=1.30,95% CI= 0.87~ 1.94,P=0.20 ] and patient satisfaction [ OR=0.42,95% CI= 0.21~ 0.84,P=0.01 ].Conclusion: Compared with the widely used traditional multi-incision laparoscopic surgery,single-incision laparoscopy is safe,reliable and feasible,which can bring a better cosmetic effect,so an single-port laparoscopic surgery can be considered for the ones who have high aesthetic requirements.