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Laparoscopic versus open appendectomy for complicated appendicitis in high risk patients
G Werkgartner1, H Cerwenka, A El Shabrawi
1Department of Surgery, Division for General Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Graz, Austria.
International Journal of Colorectal Disease
|December 17, 2014
Summary
Laparoscopic appendectomy is safe for high-risk patients with complicated appendicitis, showing shorter hospital stays. While complications were slightly more frequent, severe outcomes were less common compared to open surgery.
Area of Science:
- Surgical Innovation
- Gastrointestinal Surgery
- Minimally Invasive Procedures
Background:
- Complicated appendicitis management often involves appendectomy.
- The role of laparoscopic appendectomy in high-risk patients remains debated.
- This study evaluates laparoscopic appendectomy benefits in high-risk individuals.
Purpose of the Study:
- To assess the efficacy and safety of laparoscopic appendectomy (LA) versus open appendectomy (OA) in patients with high perioperative risk (ASA 3-4).
- To compare outcomes including operation time, hospital stay, complication rates, and inflammatory markers between LA and OA.
Main Methods:
- Retrospective analysis of appendectomy patients (2006-2013).
- Patients classified by American Society of Anesthesia (ASA) score.
- Comparison between open appendectomy (OA) and laparoscopic appendectomy (LA) groups for ASA 3 and 4 patients.
Main Results:
- Laparoscopic appendectomy had a slightly longer operation time but a shorter hospital stay (p=0.05).
- More frequent minor complications occurred after LA, but severe complications were higher in the OA group (p=0.01).
- Postoperative White Blood Cell (WBC) count decrease was delayed in LA, while C-Reactive Protein (CRP) levels steadily decreased after LA (p<0.05).
Conclusions:
- Laparoscopic appendectomy is a viable option for complicated appendicitis in high-risk patients.
- LA demonstrates favorable outcomes, including reduced severe complications, despite a slightly longer procedure time.
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