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Laparoscopic appendectomy is safe and efficacious for the elderly: an analysis using the National Surgical Quality
Michael J Kim1, Fergal J Fleming, Douglas D Gunzler
1Division of Colorectal Surgery, Department of Surgery, University of Rochester, Rochester, NY, USA. michael_kim@urmc.rochester.edu
Surgical Endoscopy
|February 8, 2011
Summary
Laparoscopic appendectomy is safe for elderly patients, showing no major complications and fewer minor ones. This approach also leads to a shorter hospital stay compared to open surgery.
Area of Science:
- Surgery
- Geriatric Medicine
- Gastroenterology
Background:
- Laparoscopic appendectomy use is increasing, but data on elderly outcomes are limited.
- Elderly patients undergoing appendectomy require specific outcome analysis.
- This study addresses the scarcity of data on laparoscopic appendectomy in older adults.
Purpose of the Study:
- To compare 30-day postoperative morbidity between open and laparoscopic appendectomy in patients over 65.
- To evaluate the length of hospital stay for elderly patients undergoing different appendectomy techniques.
Main Methods:
- Retrieved data from the National Surgical Quality Improvement Project (NSQIP) database for patients aged 65+ with appendicitis.
- Compared demographics, preoperative comorbidities, and postoperative complication rates (major and minor) between open and laparoscopic appendectomy groups.
- Utilized univariate and multivariate analyses to adjust for group differences and compare outcomes including length of hospital stay.
Main Results:
- A total of 3,335 patients underwent appendectomy; 67% received laparoscopic procedures.
- Open appendectomy patients were older with more comorbidities; however, operative times were similar.
- Laparoscopic appendectomy was associated with significantly lower rates of major and minor complications and a shorter hospital stay (2 days vs. 4 days) compared to open surgery.
Conclusions:
- Laparoscopic appendectomy is a safe and effective procedure for elderly patients.
- The technique demonstrated no correlation with major complications and a beneficial association with minor complications within 30 days.
- Laparoscopy is associated with a shorter hospital stay compared to open appendectomy in the elderly, even after adjusting for perioperative factors.
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