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Laparoscopic appendectomy for complicated appendicitis: an evaluation of postoperative factors
C G Ball1, J B Kortbeek, A W Kirkpatrick
1Department of Surgery, Foothills Medical Centre, University of Calgary, 1403-29 Street NW, T2 N 2T9, Calgary, Alberta, Canada. cgball@ucalgary.ca
Background:
The use of laparoscopic appendectomy for complicated appendicitis is controversial. Outcomes were compared between patients who had complicated appendicitis and those who had uncomplicated appendicitis.
Methods:
Consecutive patients (n = 304) who underwent laparoscopic appendectomy were studied. Patients undergoing open appendectomies also were compared ad hoc. Analgesia use, length of hospital stay, return to activity, and complication rates for the complicated and uncomplicated appendicitis subgroups were analyzed.
Results:
Complete data were available for 243 patients (80%). There were no statistical differences in characteristics between the two groups. The operating times, lengths of hospital stay, return to activity times, complication rates, and analgesia requirements, both in the hospital and after discharge, were equivalent. A greater number of complicated cases required open conversion. Considering those with complicated appendicitis, the open group had a significantly longer mean hospital stay and a higher complication rate than those treated with laparoscopic appendectomy.
Conclusions:
The minimally invasive laparoscopic technique is safe and efficacious. It should be the initial procedure of choice for most cases of complicated appendicitis.