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Interval appendectomy in the laparoscopic era.
D B Nguyen1, W Silen, R A Hodin
1Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
Summary
Interval laparoscopic appendectomy (ILA) is a safe and effective outpatient procedure for periappendiceal masses, offering shorter hospital stays and quicker recovery than open appendectomy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Periappendiceal masses often improve with antibiotics and drainage.
- The role of interval appendectomy after initial treatment remains debated.
- Laparoscopic versus open approaches for interval appendectomy have not been extensively compared.
Purpose of the Study:
- To compare the outcomes of interval laparoscopic appendectomy (ILA) and interval open appendectomy (IOA).
- To evaluate the safety, efficacy, and recovery associated with ILA.
- To assess trends in the management of periappendiceal masses over a decade.
Main Methods:
- Retrospective review of 56 patients who underwent interval appendectomy for periappendiceal mass or abscess.
- Comparison of data between two time periods (1987-1993 and 1994-1997).
- Analysis of patient characteristics, initial hospitalization, operative details, and follow-up outcomes.
Main Results:
- The use of interval laparoscopic appendectomy increased significantly from 30% to 85%.
- Interval laparoscopic appendectomy resulted in a shorter hospital stay (0.55 days vs. 3.07 days) and outpatient procedures became more common.
- No significant differences in operating room time or infection rates were observed between ILA and IOA.
Conclusions:
- Interval laparoscopic appendectomy is a safe, simple, and effective procedure with minimal morbidity.
- ILA is often suitable for outpatient management, leading to faster return to activities.
- Consideration of ILA for most patients with periappendiceal masses is recommended.