Laparoscopy or not: a meta-analysis of the surgical effects of laparoscopic versus open appendicectomy

Both open appendicectomy and laparoscopic appendicectomy have their own advantages and disadvantages. The purpose of our meta-analysis is to compare the surgical effects of laparoscopic versus open appendicectomy. In our study, Medline, Embase, and the Cochrane Library were searched. Only prospective randomized controlled trials that compared the 2 methods of operation were included. Evaluation indexes in our study involved are operating time, complications, hospital stay, time to return to normal activities, time to return to normal diet, and the overall cost. Results showed that operating time of laparoscopic appendicectomy was significantly longer [weighted mean difference (WMD) 7.60; 95% confidence interval (CI) 6.03-9.17 min; P<0.00001]. Time of hospital stay (WMD -0.82; 95% CI: -0.93 to -0.70 d), time to return to normal activities (WMD -6.85; 95% CI: -7.62 to -6.09 d), and diet (WMD -0.61; 95% CI: -0.86 to -0.36 d) were significantly decreased in the laparoscopic appendicectomy group (all P<0.00001). There is no convincing difference in complications (odds ratio 0.99; 95% CI: 0.80-1.22; P=0.92) and death rates (odds ratio 0.97; 95% CI: 0.29-3.25; P=0.96). In conclusion, laparoscopic appendicectomy may have advantages over open appendicectomy in hospital stay and postoperative recovery.