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Laparoscopic versus open appendectomy for complicated appendicitis.

Kwok Kay Yau¹, Wing Tai Siu, Chun Ngai Tang

¹Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong.

Journal of the American College of Surgeons

|July 10, 2007

Summary

Laparoscopic appendectomy is a safe and effective treatment for complicated appendicitis. This minimally invasive approach offers shorter operative times, reduced wound infections, and shorter hospital stays compared to open surgery.

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Area of Science:

General Surgery
Minimally Invasive Surgery
Gastrointestinal Surgery

Background:

Laparoscopic appendectomy is standard for uncomplicated appendicitis, offering benefits like reduced pain and infection.
The efficacy of laparoscopy for complicated appendicitis (gangrenous, perforated, abscess) is not well-defined.
Current treatment selection for complicated appendicitis often relies on surgeon preference.

Purpose of the Study:

To evaluate the feasibility, safety, and efficacy of laparoscopic appendectomy for complicated appendicitis.
To compare perioperative outcomes of laparoscopic versus open appendectomy in complicated cases.

Main Methods:

Retrospective analysis of 1,133 appendicitis cases (January 1999-January 2004).
Diagnostic laparoscopy confirmed complicated appendicitis in 244 patients.
Comparison of laparoscopic appendectomy (LA, n=175) and open appendectomy (OA, n=69) outcomes.

Main Results:

Laparoscopic appendectomy (LA) had a shorter mean operative time (55 vs. 70 minutes) and hospital stay (5 vs. 6 days) than open appendectomy (OA).
Wound infection rates were significantly lower in the LA group (0.6% vs. 10%).
Intra-abdominal collections were similar between groups (5.7% LA vs. 4.3% OA).

Conclusions:

Laparoscopic appendectomy is a feasible and safe option for complicated appendicitis.
The procedure is associated with improved outcomes, including reduced operative time, wound infections, and length of hospital stay.
Laparoscopic appendectomy offers advantages over open appendectomy for managing complicated appendicitis.