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Outcomes of laparoscopic versus open appendectomy
Alfredo M Carbonell1, Justin M Burns, Amy E Lincourt
1Carolinas Laparoscopic and Advanced Surgery Program, Department of General Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.
The American Surgeon
|October 16, 2004
Summary
Laparoscopic appendectomy (LA) is superior to open appendectomy (OA) for appendicitis treatment. LA offers reduced pain, shorter hospital stays, and similar safety, making it the preferred surgical approach.
Area of Science:
- Surgical Innovation
- Gastrointestinal Surgery
- Comparative Effectiveness Research
Background:
- The optimal surgical method for appendicitis, laparoscopic appendectomy (LA) versus open appendectomy (OA), remains debated.
- Appendectomy is a common surgical procedure worldwide, necessitating evidence-based practice guidelines.
Purpose of the Study:
- To compare the clinical outcomes and economic impact of laparoscopic appendectomy (LA) versus open appendectomy (OA).
- To determine the preferred surgical approach for appendicitis based on patient outcomes and cost-effectiveness.
Main Methods:
- A 5-year retrospective review of patients undergoing appendectomy.
- Standard statistical methods were employed to analyze outcomes, with P < 0.05 considered significant.
Main Results:
- Laparoscopic appendectomy (LA) was performed in 207 patients, and open appendectomy (OA) in 100 patients (6.7% conversion rate).
- LA patients experienced significantly less analgesic requirement (19.2 mg vs 31.5 mg) and shorter hospital stays (27.2 hours vs 53.1 hours) compared to OA patients.
- While operating room charges were higher for LA ($3839 vs $2528), total hospital charges were comparable ($8801 vs $9147), and complication rates were similar (3.6% vs 8%).
Conclusions:
- Laparoscopic appendectomy (LA) is recommended as the procedure of choice for appendicitis, irrespective of patient age, sex, BMI, or inflammation severity.
- LA offers comparable safety and operative time to OA, with added benefits of reduced postoperative pain and shorter hospitalizations, without increasing overall healthcare costs.
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