LETTER TO Pure Transvaginal Appendectomy Versus Traditional Laparoscopic Appendectomy: More Procedure Time but Less Length of Hospital Stay To the Editor: read with great interest the article by Roberts et al.1 I want to thank the authors and the journal for the first published study that compares transvaginal (TVA) and traditional laparoscopic appendectomies (LA). Their study included 18 patients in TVA and 22 patients in LA groups. They reported that ‘‘mean operative time (TVA: 44.4 4.5 minutes vs LA: 39.8 2.6 minutes,
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P ¼ 0.38) and mean length of hospital stay (TVA: 1.1 0.1 days vs LA: 1.2 0.1 days, P ¼ 0.53) were not statistically significant.’’ They also commented that similar operative times could be attributed to the single incision of the TVA, previous single port experience of the surgeon, and the assistance of the gynecologists. According to my statistical analysis, there were statistically significant differences between the groups by the means of operating time and length of hospital stay. When I compared the operating time with Student t test as mentioned by the authors (TVA—n: 18, mean: 44.4 minutes, standard deviation: 4.5 minutes vs LA—n: 22, mean: 39.8 minutes, standard deviation: 2.6 minutes), the P value was less than 0.001, not 0.38 as published in the journal. Similarly, the P value of length of hospital stay was 0.0034, not 0.53. The means of both groups can be
seen as very close to each other; however, it is not possible to say that there is no statistically significant difference between the groups. Authors found that postoperative analgesic requirement was less and work-off time was shorter in the TVA group. I believe that the new P values do not make any discordance with these results and may support them. Cuneyt Kayaalp, MD Department of Surgery Inonu University Malatya, Turkey [email protected]
REFERENCE 1. Roberts KE, Solomon D, Mirensky T, et al. Pure transvaginal appendectomy versus traditional laparoscopic appendectomy for acute appendicitis: a prospective cohort study. Ann Surg. 2012;255:266– 2669.
Disclosure: The authors declare no conflicts of interest. Copyright ß 2015 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0003-4932/14/26105-0821 DOI: 10.1097/SLA.0000000000000693
Annals of Surgery Volume 262, Number 6, December 2015
www.annalsofsurgery.com | e109
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
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EDITOR
P ¼ 0.38) and mean length of hospital stay (TVA: 1.1 0.1 days vs LA: 1.2 0.1 days, P ¼ 0.53) were not statistically significant.’’ They also commented that similar operative times could be attributed to the single incision of the TVA, previous single port experience of the surgeon, and the assistance of the gynecologists. According to my statistical analysis, there were statistically significant differences between the groups by the means of operating time and length of hospital stay. When I compared the operating time with Student t test as mentioned by the authors (TVA—n: 18, mean: 44.4 minutes, standard deviation: 4.5 minutes vs LA—n: 22, mean: 39.8 minutes, standard deviation: 2.6 minutes), the P value was less than 0.001, not 0.38 as published in the journal. Similarly, the P value of length of hospital stay was 0.0034, not 0.53. The means of both groups can be
seen as very close to each other; however, it is not possible to say that there is no statistically significant difference between the groups. Authors found that postoperative analgesic requirement was less and work-off time was shorter in the TVA group. I believe that the new P values do not make any discordance with these results and may support them. Cuneyt Kayaalp, MD Department of Surgery Inonu University Malatya, Turkey [email protected]
REFERENCE 1. Roberts KE, Solomon D, Mirensky T, et al. Pure transvaginal appendectomy versus traditional laparoscopic appendectomy for acute appendicitis: a prospective cohort study. Ann Surg. 2012;255:266– 2669.
Disclosure: The authors declare no conflicts of interest. Copyright ß 2015 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0003-4932/14/26105-0821 DOI: 10.1097/SLA.0000000000000693
Annals of Surgery Volume 262, Number 6, December 2015
www.annalsofsurgery.com | e109
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
