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.