Does laparoscopic appendectomy impart an advantage over open appendectomy in elderly patients?

Area of Science:

• Geriatric Surgery
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Laparoscopic appendectomy (LA) use is rising in elderly populations.
• Limited comparative data exists for LA versus open appendectomy (OA) in this demographic.
• Elderly patients exhibit higher rates of perforated appendicitis.

Purpose of the Study:

• To compare outcomes of LA and OA in elderly patients (≥ 65 years).
• To evaluate efficacy in both perforated and nonperforated appendicitis.
• To assess safety, mortality, length of stay, and costs.

Main Methods:

• Utilized the Nationwide Inpatient Sample database (2006-2008).
• Analyzed clinical data of elderly patients undergoing urgent appendectomy.
• Compared outcomes between laparoscopic and open approaches.

Main Results:

• LA utilization increased from 46.5% to 57.8% in elderly patients (2006-2008).
• For nonperforated appendicitis, LA showed lower complication rates, mortality, charges, and LOS.
• For perforated appendicitis, LA also demonstrated reduced complications, mortality, charges, and LOS compared to OA.

Conclusions:

• Laparoscopic appendectomy is safe and advantageous for elderly patients.
• LA should be the preferred procedure for both perforated and nonperforated appendicitis in this age group.
• LA offers improved outcomes and resource utilization.