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Conversion from laparoscopic to open appendicectomy: a possible drawback of the laparoscopic technique?
A Hellberg1, C Rudberg, L Enochsson
1Department of Surgery, Central Hospital Västerås, Sweden.
The European Journal of Surgery = Acta Chirurgica
|April 24, 2001
Summary
Conversion from laparoscopic to open appendicectomy was often due to difficult anatomy or abscesses. Patients converted experienced longer recovery times, but complication rates remained similar.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
Background:
- Appendicectomy is a common surgical procedure.
- Laparoscopic appendicectomy is increasingly preferred, but conversion to open surgery may be necessary.
Purpose of the Study:
- To analyze reasons for and outcomes of conversion from laparoscopic to open appendicectomy.
- To identify predictors for conversion during appendicectomy.
Main Methods:
- Subgroup analysis from a randomized multicenter study.
- 500 patients randomized to laparoscopic (n=244) or open (n=256) appendicectomy.
- Analysis of conversion reasons, outcomes, and preoperative predictive variables.
Main Results:
- 12% (30/500) of laparoscopic appendicectomies were converted to open procedures.
- Difficult anatomy and abscesses were the primary reasons for conversion (25/30).
- Conversion was associated with longer operating time, anesthetic time, hospital stay, and recovery, except in cases of perforated appendicitis. No significant difference in complication rates was observed.
Conclusions:
- Difficult anatomy and abscesses are the main drivers for conversion in appendicectomy.
- Conversion to open appendicectomy leads to a slower recovery compared to primary laparoscopic or open procedures.