New strategy during complicated open appendectomy: convert open operation to laparoscopy.

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Complicated appendectomies often require open surgical approaches.
• Traditional open appendectomies can lead to prolonged recovery and higher complication rates.

Purpose of the Study:

• To evaluate the feasibility and efficacy of converting open appendectomies to laparoscopic procedures in complicated cases.
• To compare outcomes between lengthened-incision open appendectomies (LIA) and open appendectomies converted to laparoscopy (OACL).

Main Methods:

• Retrospective review of 214 complicated appendectomies (155 LIA, 59 OACL) across two institutions.
• Comparison of patient characteristics, incision length, recovery time, drainage rates, pain levels, hospital stay, and complication rates between the LIA and OACL groups.

Main Results:

• The OACL group demonstrated significantly shorter incision lengths (3.8 cm vs 6.2 cm), faster flatus recovery (2.3 days vs 4.2 days), lower drainage rates (61% vs 80%), reduced pain levels (3.6 vs 7.2), shorter hospital stays (5.1 days vs 8.7 days), and lower complication rates (8.5% vs 14.7%) compared to the LIA group.
• No major complications or deaths were reported in either group.
• Patient characteristics were similar between the groups.

Conclusions:

• Converting open appendectomies to laparoscopy (OACL) is a feasible and effective strategy for complicated appendicitis.
• The OACL approach significantly improves patient outcomes by reducing complications, pain, and hospital stay.
• Lengthened-incision open appendectomy (LIA) is associated with increased complications and longer hospitalizations.