Outcome comparison between laparoscopic and open appendectomy: evidence from a nationwide population-based study

Area of Science:

• Surgical Innovation
• Gastrointestinal Surgery
• Public Health Research

Background:

• Laparoscopic appendectomy is increasingly used for simple appendicitis.
• Previous studies suggest limited clinical relevance of its advantages.
• This study evaluates outcomes of laparoscopic versus open appendectomy in Taiwan.

Purpose of the Study:

• To compare treatment outcomes between laparoscopic and open appendectomies.
• To analyze 30-day re-admission rates, length of stay, and cost per discharge.
• To assess the clinical relevance of laparoscopic appendectomy advantages.

Main Methods:

• Utilized data from Taiwan's National Health Insurance Research Database (2007-2009).
• Analyzed 65,339 patients diagnosed with acute appendicitis.
• Employed generalized estimating equations and hierarchical linear regressions for outcome analysis.

Main Results:

• Laparoscopic appendectomy patients had significantly lower 30-day re-admission rates (0.66% vs. 1.925%).
• Laparoscopic procedures resulted in shorter length of stay (4.01 vs. 5.33 days).
• Laparoscopic appendectomies incurred a slightly higher cost per discharge (NT$40,554 vs. NT$38,509).

Conclusions:

• Laparoscopic appendectomies are associated with reduced 30-day re-admission rates.
• Shorter length of stay is a key benefit of the laparoscopic approach.
• While costs are marginally higher, laparoscopic appendectomy offers improved patient outcomes.