The laparoscopic approach for perforated appendicitis, including cases complicated by abscess formation

Area of Science:

• Surgical Gastroenterology
• Minimally Invasive Surgery
• Appendicitis Management

Background:

• Laparoscopic surgery for perforated appendicitis is common but debated due to potential complications.
• Complications can range from gangrenous changes to diffuse peritonitis with abscess formation.
• Evaluating the safety and benefits of laparoscopic versus open surgery for perforated appendicitis, including cases with abscess, is crucial.

Purpose of the Study:

• To compare the safety and efficacy of laparoscopic appendectomy versus open surgery for perforated appendicitis.
• To specifically assess outcomes in patients with perforated appendicitis complicated by abscess formation.
• To determine if laparoscopic approach offers advantages in terms of recovery and complications.

Main Methods:

• A retrospective analysis of 1747 patients treated for appendicitis over 3 years.
• Diagnosis of perforated appendicitis confirmed via radiology, operative findings, and pathology.
• Surgeons utilized either open surgery (3 surgeons) or laparoscopy (2 surgeons) for perforated appendicitis cases.

Main Results:

• Of 1747 patients, 474 had perforated appendicitis without abscess and 113 had perforated appendicitis with abscess.
• Laparoscopy group showed shorter duration for diet resumption and hospital stay compared to the open group.
• No significant differences in postoperative complications (intra-abdominal abscesses, wound infections) were observed between laparoscopic and open approaches, both with and without abscess.

Conclusions:

• Laparoscopic surgery is a safe and effective treatment for perforated appendicitis.
• The laparoscopic approach is also suitable for perforated appendicitis cases complicated by abscess formation.
• Laparoscopic surgery demonstrates comparable safety to open surgery with potential benefits in recovery time.