[Laparoscopic appendectomy in acute appendicitis]

Area of Science:

• Surgical Innovation
• Gastrointestinal Surgery
• Minimally Invasive Procedures

Context:

• Acute appendicitis management presents challenges in optimizing surgical outcomes.
• Minimally invasive techniques, particularly laparoscopic appendectomy, are increasingly preferred.
• Evaluating different laparoscopic approaches and prophylactic measures is crucial for reducing complications.

Purpose:

• To compare the efficacy and complication rates of three minimally-invasive appendectomy techniques.
• To evaluate a modified laparoscopic appendectomy with a prophylactic complex.
• To present an algorithm for differential approaches to minimally-invasive appendectomy.

Summary:

• 156 patients with acute appendicitis underwent minimally-invasive operations: laparoscopic appendectomy (F. Gotz ligature method), combined appendectomy, and a modified laparoscopic method with a prophylactic complex.
• Conversion to open surgery was infrequent (3.8%). Overall complication rates were 5.1% intraoperatively and 6.4% postoperatively, with variations across groups (1.7%-10.9%).
• Bacterial examination results and a postoperative complication prophylaxis program are detailed, alongside an algorithm for selecting the appropriate minimally-invasive appendectomy method.

Impact:

• Provides data on the comparative effectiveness of different laparoscopic appendectomy techniques.
• Highlights the potential benefits of a modified laparoscopic approach combined with prophylactic measures.
• Offers a structured approach to guide surgical decision-making in acute appendicitis cases.