Single-incision versus conventional multiport laparoscopic-assisted surgery for Meckel's diverticulum in children: a single-center propensity score analysis.

Background: Meckel's diverticulum (MD) is the most common congenital anomaly of the small intestine, and often leads to various complications in children. This study aims to compare the efficacy and safety of single-incision laparoscopic surgery (SILS) and conventional laparoscopic surgery (CLS) in the treatment of MD in children.

Methods: Retrospective review of patients who underwent laparoscopic surgery for MD at a tertiary pediatric hospital from February 2017 to February 2023 was conducted with registered of demographic information, preoperative laboratory results, operative findings, and postoperative outcomes. Based on the surgical strategy, patients were classified into SILS and CLS groups. Propensity score matching (PSM) was employed to adjust for confounding factors, resulting in 188 matched pairs. Using PSM, the two groups were compared for baseline differences and postoperative outcomes.

Results: Of the 561 patients, the SILS-to-CLS ratio was 301: 260. After one-to-one PSM, results showed that compared with the CLS group, the SILS group had a significantly shorter postoperative hospital stay (P = 0.004), and earlier excretion time and fasting time (P < 0.05). Furthermore, SILS resulted in better scar assessment and higher satisfaction score (both P < 0.05). The two groups had no significant differences in the rates of postoperative complications (P = 0.439) and readmission (P = 0.291). Conversion to open surgery was more common in the SILS group (10.6%) than in the CLS group (6.4%), although this difference was not statistically significant after matching (P = 0.139).

Conclusion: Our study aimed to determine the superiority of SILS over CLS in the treatment of pediatric MD. SILS offers distinct advantages over CLS in managing MD in children, including shorter hospital stays and bowel function recovery, without increasing postoperative complications. These findings suggest that SILS may be a preferable approach, warranting its integration into standard clinical practice for MD treatment.