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Asian J Endosc Surg ISSN 1758-5902
L E T T E R TO T H E E D I TO R
Re: Postoperative pain between single-incision and conventional laparoscopic appendectomy Sir, the report on postoperative pain between singleincision and conventional laparoscopic appendectomy is very interesting (1). Miyauchi et al. reported that “. . .SLA, which results in similar postoperative pain as CLA, is a feasible technique for uncomplicated appendicitis in children” (1). In fact, there are many factors, including psychological factors, that contribute to postoperative pain in pediatric patients. The parameters studied by Miyauchi et al., such as the frequency of postoperative analgesic requirement, might not directly reflect the presence of pain in children. To measure pain in children, Khin Hla et al. noted that “[c]hildren’s pain self-reports should be used wherever possible to guide management, but in their absence, parental pain scores can be reliably used as a surrogate measure” (2). In addition, another parameter in the report by Miyauchi et al., length of hospital stay, differed from a previous report by Liang et al. (1,3). Liang et al. found that SLA required a longer hospital stay (3). Also, according to a meta-analysis that confirmed no difference in surgical result between SLA and CLA, SLA requires a longer operation time, which could imply an increased risk (4).
References 1. Miyauchi Y, Sato M, Hattori K. Comparison of postoperative pain between single-incision and conventional laparoscopic appendectomy in children. Asian J Endosc Surg 2014; Nov; 24(11): 1127–31. doi: 10.1111/pan.12484 [Epub ahead of print]. 2. Khin Hla T, Hegarty M, Russell P et al. Perception of Pediatric Pain: A comparison of postoperative pain assessments between child, parent, nurse, and independent observer. Paediatr Anaesth 2014. doi: 10.1111/pan.12484 [Epub ahead of print]. 3. Liang HH, Hung CS, Wang W et al. Single-incision versus conventional laparoscopic appendectomy in 688 patients: A retrospective comparative analysis. Can J Surg 2014; 57: E89– E97. 4. Antoniou SA, Koch OO, Antoniou GA et al. Meta-analysis of randomized trials on single-incision laparoscopic versus conventional laparoscopic appendectomy. Am J Surg 2014; 207: 613–622.
Viroj Wiwanitkit Hainan Medical University, Haikou, China
100
Asian J Endosc Surg 8 (2015) 100 © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.
Asian J Endosc Surg ISSN 1758-5902
L E T T E R TO T H E E D I TO R
Re: Postoperative pain between single-incision and conventional laparoscopic appendectomy Sir, the report on postoperative pain between singleincision and conventional laparoscopic appendectomy is very interesting (1). Miyauchi et al. reported that “. . .SLA, which results in similar postoperative pain as CLA, is a feasible technique for uncomplicated appendicitis in children” (1). In fact, there are many factors, including psychological factors, that contribute to postoperative pain in pediatric patients. The parameters studied by Miyauchi et al., such as the frequency of postoperative analgesic requirement, might not directly reflect the presence of pain in children. To measure pain in children, Khin Hla et al. noted that “[c]hildren’s pain self-reports should be used wherever possible to guide management, but in their absence, parental pain scores can be reliably used as a surrogate measure” (2). In addition, another parameter in the report by Miyauchi et al., length of hospital stay, differed from a previous report by Liang et al. (1,3). Liang et al. found that SLA required a longer hospital stay (3). Also, according to a meta-analysis that confirmed no difference in surgical result between SLA and CLA, SLA requires a longer operation time, which could imply an increased risk (4).
References 1. Miyauchi Y, Sato M, Hattori K. Comparison of postoperative pain between single-incision and conventional laparoscopic appendectomy in children. Asian J Endosc Surg 2014; Nov; 24(11): 1127–31. doi: 10.1111/pan.12484 [Epub ahead of print]. 2. Khin Hla T, Hegarty M, Russell P et al. Perception of Pediatric Pain: A comparison of postoperative pain assessments between child, parent, nurse, and independent observer. Paediatr Anaesth 2014. doi: 10.1111/pan.12484 [Epub ahead of print]. 3. Liang HH, Hung CS, Wang W et al. Single-incision versus conventional laparoscopic appendectomy in 688 patients: A retrospective comparative analysis. Can J Surg 2014; 57: E89– E97. 4. Antoniou SA, Koch OO, Antoniou GA et al. Meta-analysis of randomized trials on single-incision laparoscopic versus conventional laparoscopic appendectomy. Am J Surg 2014; 207: 613–622.
Viroj Wiwanitkit Hainan Medical University, Haikou, China
100
Asian J Endosc Surg 8 (2015) 100 © 2015 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.
