PT  - JOURNAL ARTICLE
AU  - Muhammad Shafique Sajid
AU  - Munir Ahmad Khan
AU  - Elizabeth Cheek
AU  - Mirza Khurrum Baig
TI  - Needlescopic versus laparoscopic appendectomy: a systematic review
DP  - 2009 Apr 01
TA  - Canadian Journal of Surgery
PG  - 129--134
VI  - 52
IP  - 2
4099  - http://canjsurg.ca/content/52/2/129.short
4100  - http://canjsurg.ca/content/52/2/129.full
SO  - CAN J SURG2009 Apr 01; 52
AB  - Background Needlescopic appendectomies (NA) have been performed since the 1990s. We sought to systematically analyze trials comparing NA with laparoscopic appendectomies (LA) in the management of appendicitis.Methods We performed a systematic review of the literature. We compared and analyzed clinical trials on NA and LA to generate summative data expressed as standardized mean differences (SMD).Results Of 5 retrieved trials from the electronic database 2 trials involving 412 patients met our inclusion criteria. In the fixed-effects models, NA took longer than LA, and this time difference was statistically significant: SMD 0.20 min, 95% confidence interval 0.01–0.40, p = 0.030, z1 = 2.09. In both fixed- and random-effects models, the difference in total hospital stay and in perioperative complications between the NA and LA groups were nonsignificant. Furthermore, in both fixed- and random-effects models, NA was associated with a higher conversion rate to open appendectomy than LA. There was no heterogeneity between the trials (Q = 0.34, p = 0.55).Conclusion Needlescopic appendectomy can be a safe and effective procedure for the management of appendicitis. It is comparable to LA in terms of hospital stay and perioperative complications. However, NA is associated with a longer duration of surgery and a higher conversion rate, indicating technical challenges of the procedure. Before recommending routine use of the needlescopic technique for appendectomy, a major multicentre randomized controlled trial is necessary.