Comparison of Single-Incision and Conventional Laparoscopic Sleeve Gastrectomy for Morbid Obesity: a Meta-Analysis
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ORIGINAL CONTRIBUTIONS
Comparison of Single-Incision and Conventional Laparoscopic Sleeve Gastrectomy for Morbid Obesity: a Meta-Analysis Si-Da Sun 1 & Ping-Ping Wu 2 & Jun-Feng Zhou 1 & Zhi-Sheng Wang 1 & Tian-Hong Cai 1 & Long-Kai Huang 1 & Jian-Sheng Chen 1 & Chang-Qing Lin 1 & Jia-Xing Wang 1 & Qing-Liang He 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Single-incision laparoscopic sleeve gastrectomy (SILSG) has been proposed as an alternative to conventional laparoscopic sleeve gastrectomy (CLSG) in obese patients. This study aims to compare the surgical outcomes of these two techniques. Methods A meta-analysis of existing literature obtained through a systematic literature search in the PubMed, EMBASE, and Cochrane Library CENTRAL databases from 2009 to 2019 was conducted. Results Eleven articles including 1168 patients were analyzed. Patients in the SILSG group reported greater satisfaction with cosmetic scar outcomes than those in the CLSG group (SMD = 2.47, 95% CI = 1.10 to 3.83, P = 0.00). There was no significant difference between the SILSG group and the CLSG group regarding operative time, intraoperative estimated blood loss, conversion rate, intraoperative complications, length of hospital stay, postoperative analgesia, postoperative complications, excess weight loss (EWL), and improvements in comorbidities (P > 0.05). Conclusions Compared to CLSG, SILSG resulted in improved cosmetic satisfaction and showed no disadvantages in terms of surgical outcomes; thus, SILSG can serve as an alternative to CLSG for obese patients. Nonetheless, high-quality randomized controlled trials (RCTs) with large study populations and long follow-up periods are needed. Keywords Morbid obesity . Single-incision sleeve gastrectomy . Laparoscopic sleeve gastrectomy . Sleeve gastrectomy
Introduction In recent decades, the number of obese patients has increased rapidly, and the prevalence of obesity and related metabolic diseases has also increased substantially worldwide [1]. Bariatric surgery is currently recognized as the most effective method to treat obesity and related metabolic diseases; it can not only promote sustained and stable weight loss effects (WLEs) but also significantly alleviate obesity-related metabolic diseases [2]. As an independent bariatric surgery, laparoscopic sleeve gastrectomy was the most frequently
* Qing-Liang He [email protected] 1
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China
2
Department of General Medicine, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China
performed bariatric procedure globally in 2014 [3]. Since the first case of single-incision laparoscopic sleeve gastrectomy (SILSG) was reported in 2008 [4], an increasing number of such cases have been reported. By 2018, 2028 patients had been reported to have undergone SILSG [5]. Compared with conventional laparoscopic sleeve gastrectomy (CL
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