Laparoscopic appendectomy for complicated appendicitis: a comparison with open appendectomy.

Abstract:

BACKGROUND:Although laparoscopic appendectomy (LA) is widely performed in many countries, LA for complicated appendicitis, which includes perforated or gangrenous appendicitis with or without localized or disseminated peritonitis, has not become a common practice yet. METHODS:We retrospectively analyzed the clinical records of 230 patients who had undergone appendectomy for complicated appendicitis: 141 had undergone LA, 84 had conventional open appendectomy (OA), and 5 patients had conversion to the open procedure after laparoscopy. The LA group (total LA) was subdivided into "early experience (early LA: cases 1-56)" and "late experience (late LA: case 57 and higher)." We defined the early LA group as the comparison group to minimize selection bias. RESULTS:Patient demographics were similar in the early LA and OA groups (P > 0.05). Wound infection was significantly more frequent in the OA group (P < 0.05). Intra-abdominal infection was equally common in these two groups. The overall rate of postoperative complications was significantly higher in the OA group (32.1%) than in the early LA group (18%; P < 0.05). This incidence was 12.8% in the total LA group. Hospital stay was significantly shorter in the early LA group (10.6 +/- 3.9 days; P < 0.05), and 8.9 +/- 3.7 days in the total LA group. CONCLUSIONS:Our findings indicate that LA is safe and useful even for the treatment of complicated appendicitis if performed by an experienced surgeon.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Katsuno G,Nagakari K,Yoshikawa S,Sugiyama K,Fukunaga M

doi

10.1007/s00268-008-9843-y

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

208-14

issue

2

eissn

0364-2313

issn

1432-2323

journal_volume

33

pub_type

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