P < 0.05 selleck screening library was considered significant. Analysis was performed using Stata (StataCorp. 2007. Stata Statistical Software: Release 10. College Station, TX: StataCorp LP) 3. Results Between July 2009 and March 2010, 87 patients were randomized for suspected appendicitis into the SPAA group (SPAAG) or an LA group (LAG). There were 46 patients in the SPAA group and 41 in the LA group. The mean age of the patients was 34,2 (17�C73) for the SPAA group and 37,7 (19�C69) for the LA group. There were 19 males and 27 females in the SPAA group and 22 males and 19 females in the LA group (Table 1). SILS Port was used in 38 patients and TriPort in 8 patients and there was no technical difference between them. In spite of technical difficulties and disorientation specially in the first few cases, the mean operative time was 40,4 minutes in the SPAA group and 35, 0 minutes in the LA group (P = 0,110).

In only 1 patient of the SPAA group, the procedure was converted to an open approach due to technical difficulties in a colonic cancer diagnosed during the surgery. Complications occurred in 2 patients, all in the SPPA group. First patient presented with acute coronary syndrome during the surgery; another young woman suffered of an acute pulmonary oedema caused by an allergic reaction to Dexketoprofen who required 5 days endotracheal intubation. The two patients presented a long hospital stay (7 days, 11 days, and 10 days resp.). All these hospital stays have been included in the mean of the postoperative stay at hospital. Drains have been used in 8 and 5 patients in each group because of the local peritonitis found (Tables (Tables22 and and33).

Table 2 Results concerning operative technique. Table 3 Postoperative results and outcomes. Oral intake was accomplished after 12,5 hours in the SPAA group and 10,7 hours in the LA group. The mean hospital stay was 44,4 hours in the SPAA group (mean 14�C264) and 34,0 hours (mean 11�C96) in the LA group. Pain was evaluated and was 2,8 in the SPAA group and 2,9 in the LA group, according to the AVS after 24 hours. The degree of satisfaction was higher in the SPAA group (7,5 versus 6,9) (P < 0.05). Same results were found for the cosmetic result (8,6 versus 7,4) (P < 0.05). At three-month followup, no hernia or other complications have appeared. 4. Discussion Many surgical research groups have developed new surgical technique called Natural Orifice Transluminal Endoscopic Surgery (NOTES) [9].

Some appendectomies have even been performed through a vaginal approach, without visible scars [10]. However, many authors consider that umbilicus a natural orifice since its origin. For this reason, many authors have reported the feasibility of LA with a transumbilical approach, especially in children [11]. Also, some studies investigated the feasibility of SPAA in study populations ranging Carfilzomib from 1 to 200 patients, and there is not a standard use of size port in the LAG [12].