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Laparoscopic versus open appendectomy: is the postoperative infectious complication rate different?
Francesca Hoehne1, Maria Ozaeta, Bill Sherman
1Department of Surgery, Kern Medical Center, Bakersfield, California 93305, USA.
Abstract:
Despite the reported advantages of laparoscopic appendectomy (LA), there is debate about the postoperative infectious complication rate. Our study attempts to determine if the infectious complication rate between LA and open appendectomy (OA) is different. A retrospective review was conducted of all patients who underwent appendectomy at Kern Medical Center between 1999 and 2003. Age, sex, white blood cell count, temperature, pathology, and postoperative complications were identified. Fifty-seven patients underwent LA, and 159 patients underwent OA. The groups were well matched for demographics, white blood cell count, temperature, and percent perforated appendicitis. There was an overall 9.3 per cent complication rate. The infectious complication rate in OA versus LA group was statistically different (6.3% vs 17.6%, P = 0.04). The infectious complication rate in the LA group was significantly higher than in the OA group. Further large randomized trials are necessary to confirm our findings and to identify if LA is appropriate for a subset of appendicitis patients.
Insights
Laparoscopic appendectomy (LA) showed a higher infectious complication rate (17.6%) compared to open appendectomy (OA) (6.3%) in this study. Further research is needed to confirm if LA is suitable for specific appendicitis cases.
Area of Science:
- Surgery
- Gastroenterology
Background:
- Laparoscopic appendectomy (LA) offers potential benefits, but its infectious complication rates compared to open appendectomy (OA) remain debated.
- Assessing postoperative infectious complications is crucial for determining the optimal appendectomy technique.
Purpose of the Study:
- To compare the infectious complication rates between laparoscopic appendectomy (LA) and open appendectomy (OA).
- To evaluate the safety and efficacy of LA versus OA in appendicitis treatment.
Main Methods:
- Retrospective review of appendectomy patients at Kern Medical Center from 1999 to 2003.
- Data collected included demographics, white blood cell count, temperature, pathology, and postoperative complications.
- Comparison of infectious complication rates between the LA (n=57) and OA (n=159) groups.
Main Results:
- The overall complication rate was 9.3%.
- The infectious complication rate was significantly higher in the LA group (17.6%) compared to the OA group (6.3%) (P = 0.04).
- Groups were comparable in demographics, initial white blood cell count, temperature, and perforated appendicitis percentage.
Conclusions:
- Laparoscopic appendectomy was associated with a significantly higher infectious complication rate than open appendectomy in this patient cohort.
- Further large-scale randomized trials are warranted to validate these findings and identify patient subsets who may benefit from LA.
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