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Published on: June 17, 2018
Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis
1Department of Surgical Services, Brookdale University Hospital and Medical Center, Brooklyn, NY 11229, USA.
Laparoscopic appendectomy for perforated appendicitis shows lower rates of wound infection and ileus compared to open surgery. Conversion to open surgery increases postoperative complications, with no difference in intra-abdominal abscesses.
Area of Science:
- Surgical Innovation
- Gastrointestinal Surgery
- Infectious Disease
Background:
- Perforated appendicitis carries a high risk of postoperative infections.
- Laparoscopic approaches for perforated appendicitis are debated.
- The impact of conversion to open surgery is not well-defined.
Purpose of the Study:
- To compare the outcomes of laparoscopic appendectomy (LA), open appendectomy (OA), and converted appendectomy (CA) in perforated appendicitis.
- To evaluate the role of laparoscopy in managing perforated appendicitis.
- To assess the influence of conversion on postoperative morbidity.
Main Methods:
- Prospective and retrospective review of 52 patients with perforated appendicitis.
- Comparison of LA (18 patients), OA (24 patients), and CA (10 patients).
- Data collected on operative time, hospital stay, diet tolerance, and infectious complications.
Main Results:
- No significant difference in operative time or hospital stay across LA, OA, and CA groups.
- Lower wound infection rates observed in the LA group (0%) compared to OA (14%) and CA (10%).
- Higher rates of intra-abdominal abscesses (IAAs) and ileus in the CA group (60%, 50%) compared to LA (22%, 28%) and OA (38%, 29%).
Conclusions:
- Laparoscopic and open appendectomy show similar rates of intra-abdominal abscesses for perforated appendicitis.
- Laparoscopic appendectomy is associated with fewer wound infections and less ileus postoperatively.
- Conversion from laparoscopic to open appendectomy increases postoperative morbidity.
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