分析单孔对比传统三孔腹腔镜阑尾切除术治疗急性阑尾炎的临床疗效，行亚组分析探索影响单孔腹腔镜手术时间的因素，明确获益人群。

回顾性分析三个中心2019年1月至2021年5月连续收治的急性阑尾炎并行腹腔镜阑尾切除术的患者的临床资料，用倾向性匹配方法消除年龄、性别因素对结果的影响，对比单孔和传统三孔腹腔镜手术时间、术后住院时间、术后并发症的区别，行亚组分析影响单孔腹腔镜手术时间的因素。

单孔组的手术时间延长（50.42±10.661 min vs. 37.76±11.023 min，t=6.566，P=0.000），术后VAS疼痛评分降低（3.42±1.98 vs. 4.44±2.37，t=2.569，P=0.011）、需要使用镇痛药比例降低（8.3% vs. 22.9%，χ²=4.600，P=0.032）、疤痕美容SCAR评分降低（4.59±2.87 vs. 6.74±3.34，t=3.910，P=0.000），术中出血量、术后住院时间及术后并发症差异无统计学意义。Logistic回归分析发现手术方式、BMI和阑尾直径是影响手术时间的独立影响因素，亚组分析发现BMI对单孔组和三孔组的手术时间均有影响，但对单孔组的影响更大；阑尾直径对三孔组的手术时间有影响，不影响单孔组的手术时间。

单孔腹腔镜阑尾切除术治疗急性阑尾炎是一种安全、有效的方法，可减少术后疼痛，术后腹壁疤痕更美观，尤其在BMI正常、阑尾直径较大的患者中效果更佳。

The clinical efficacy of single-port laparoscopic appendectomy in the treatment of acute appendicitis was analyzed compared with traditional three-port laparoscopic appendectomy. Subgroup analysis was conducted to explore the factors affecting the operation time of single-port laparoscopic appendectomy and identify patients who benefit more.

A retrospective analysis was performed on patients with acute appendicitis and laparoscopic appendectomy admitted consecutively from January 2019 to May 2021 in three centers. The influences of age and gender on the results were eliminated by the method of propensity score matching, and the differences of operating time, postoperative hospital stay and postoperative complications between single-port laparoscopic and traditional three-port laparoscopic appendectomy were compared. Subgroup analysis was performed to analyze the factors affecting the operating time in single-port laparoscopic group.

The operative time was prolonged (50.42±10.661 min vs. 37.76±11.023 min, t=6.566, P=0.000), postoperative Visual Analogue Score was decreased (3.42±1.98 vs. 4.44±2.37, t=2.569, P=0.011), the proportion of patients needing analgesics decreased (8.3% vs. 22.9%, χ²=4.600, P=0.032) and Scar Cosmesis Assessment and Rating score was decreased (4.59±2.87 vs. 6.74±3.34, t=3.910, P=0.000) in the single-port group when compared with the three-port group. There were no significant differences in intraoperative blood loss, postoperative hospital stay and postoperative complications. Logistic regression analysis clarified that operation method, age, BMI and appendix diameter were independent influencing factors of operation time. Subgroup analysis indicated that BMI had an effect on the operation time of both the single-port group and the three-port group, but had a greater effect on the single-port group. The diameter of appendix had an effect on the operation time of the three-port group, but did not on the single-port group.

Single-port laparoscopic appendectomy is a safe and effective method for the treatment of acute appendicitis, which can reduce postoperative pain and bring better cosmesis appearance of abdominal wall, especially in patients with normal BMI and big diameter of appendix.