Laparoscopic interval appendectomy versus open interval appendectomy: a prospective randomized controlled trial.

Area of Science:

• Gastroenterology
• Surgical Innovation
• Minimally Invasive Surgery

Background:

• Appendicular phlegmon management often involves initial conservative treatment followed by interval appendectomy.
• Comparing surgical approaches for interval appendectomy is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the efficacy and outcomes of laparoscopic versus open interval appendectomy in patients with appendicular phlegmon.
• To evaluate operative time, complication rates, postoperative pain, and recovery metrics between the two surgical techniques.

Main Methods:

• A prospective randomized controlled study involving 100 patients diagnosed with appendicular phlegmon.
• Patients were randomly assigned to undergo either laparoscopic interval appendectomy (n=50) or open interval appendectomy (n=50) after initial conservative management.

Main Results:

• Laparoscopic surgery had a longer mean operative time (57.64 min) compared to open surgery (33.9 min) (P < 0.05).
• Concomitant pathology detection was higher in the laparoscopic group (16%) versus the open group (2%).
• Laparoscopic appendectomy demonstrated significantly lower postoperative pain scores, shorter duration of ileus, reduced hospital stay, and earlier return to work (P < 0.05).

Conclusions:

• Laparoscopic interval appendectomy offers significant advantages over the open approach in terms of patient recovery and postoperative experience.
• Despite a longer operative time, laparoscopy is a favorable option for interval appendectomy in selected cases of appendicular phlegmon.