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[Laparoscopic approach versus laparotomy for suspected acute appendicitis].
L Casciola1, G Ceccarelli, A Bartoli
1Divisione di Chirurgia Generale, Vascolare e Mininvasiva, ASL no 3 dell'Umbria, Spoleto, PG.
Il Giornale Di Chirurgia
|March 26, 2003
Summary
Videolaparoscopic appendectomy (VLA) offers superior diagnostic accuracy and fewer complications compared to conventional laparotomic appendectomy (CLA) for suspected acute appendicitis. VLA enables better abdominal exploration and diagnosis of associated conditions.
Area of Science:
- General Surgery
- Surgical Innovation
Background:
- Acute appendicitis diagnosis remains challenging despite advanced imaging, often relying on clinical assessment.
- Conventional laparotomic appendectomy (CLA) and videolaparoscopic appendectomy (VLA) are surgical options for suspected appendicitis.
Purpose of the Study:
- To retrospectively compare the diagnostic performance and outcomes of CLA and VLA.
- To evaluate complications and length of hospital stay for both procedures.
Main Methods:
- Retrospective analysis of 156 patients undergoing surgery for suspected acute appendicitis between January 2000 and November 2001.
- Comparison of operating time, complications, and hospital stay between VLA (96 patients) and CLA (60 patients).
Main Results:
- VLA demonstrated superior diagnostic performance, identifying alternative diagnoses in 41% of cases versus 13% for CLA.
- Fewer surgical complications (wound infections, pelvic abscesses) were observed in the VLA group compared to the CLA group.
- No significant differences in operating time or hospital stay were found between VLA and CLA.
Conclusions:
- VLA provides enhanced abdominal exploration, improved appendix localization, and better diagnosis of unexpected findings.
- Videolaparoscopic appendectomy is associated with a lower incidence of complications than conventional laparotomic appendectomy.