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Effectiveness of laparoscopic approach for acute appendicitis
Shogo Tanaka1, Daisuke Kubota, Sang Hun Lee
1Department of Surgery, Joto Central Hospital, Osaka, Japan. m8827074@msic.med.osaka-cu.ac.jp
Osaka City Medical Journal
|September 18, 2007
Summary
Laparoscopic appendectomy (LA) offers faster recovery and shorter hospital stays for acute appendicitis compared to open appendectomy (OA). However, LA has a longer operative time and risks serious complications, especially for gangrenous cases.
Area of Science:
- Surgical Procedures
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- The comparative effectiveness of laparoscopic appendectomy (LA) versus open appendectomy (OA) for acute appendicitis is debated.
- LA is a standard procedure, while OA is performed for social reasons at this institution.
Purpose of the Study:
- To compare the operative factors and postoperative outcomes of LA and OA for acute appendicitis.
- To evaluate the efficacy and safety of laparoscopic versus open appendectomy.
Main Methods:
- Retrospective review of 95 patients undergoing appendectomy for acute appendicitis (April 2002-December 2005).
- Comparison of patient characteristics, operative details, and postoperative courses between the LA group (n=62) and OA group (n=33).
Main Results:
- The OA group had more advanced appendicitis (52% gangrenous vs. 21% in LA group).
- LA had a longer operative time (80 min vs. 63 min) but resulted in earlier pain/fever recovery, less wound infection (6% vs. 27%), and shorter hospital stays (6.7 vs. 14.4 days).
- Serious complications occurred in 2 LA patients; LA showed no advantage for gangrenous appendicitis.
Conclusions:
- Laparoscopic appendectomy accelerates postoperative recovery and shortens hospitalization despite longer operative times and potential for serious complications.
- LA is generally advantageous for acute appendicitis, but careful consideration is needed for severe cases.
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