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Laparoscopic versus open surgery for complicated appendicitis in adults: a randomized controlled trial
Yoshiro Taguchi1, Shunichiro Komatsu2,3, Eiji Sakamoto2
1Department of Digestive Surgery, Nagoya Daini Red Cross Hospital, 2-9, Myoken-cho, Showa-ku, Nagoya, 466-8650, Japan. yoshirotaguchi@hotmail.com.
Surgical Endoscopy
|August 16, 2015
Summary
Laparoscopic appendectomy (LA) for complicated appendicitis (CA) is safe and feasible, but this trial did not validate its superiority over open appendectomy (OA) in reducing postoperative complications.
Area of Science:
- Surgical Innovation
- Gastrointestinal Surgery
- Clinical Trials
Background:
- Complicated appendicitis (CA) presents significant postoperative challenges.
- Open appendectomy (OA) is a traditional approach for CA.
- Laparoscopic appendectomy (LA) is an alternative surgical technique.
Purpose of the Study:
- To compare the efficacy of LA versus OA in treating CA.
- To assess the impact of LA on postoperative complications and recovery.
- To determine if LA offers advantages over OA for complicated appendicitis.
Main Methods:
- A single-center randomized controlled trial (RCT) was conducted.
- Patients with CA (peritonitis or abscess) were randomized to LA or OA.
- The primary outcome was infectious complications, particularly surgical site infection (SSI), within 30 days.
Main Results:
- 81 patients were randomized (42 LA, 39 OA).
- Surgical site infection (SSI) rates were 33.3% for LA and 25.6% for OA (p=0.476).
- No significant differences in overall postoperative complications, hospital stay, or recovery parameters were observed between groups, except for days to walking.
Conclusions:
- Laparoscopic appendectomy (LA) is a safe and feasible option for complicated appendicitis (CA).
- This clinical trial did not demonstrate a significant benefit of LA over open appendectomy (OA) in reducing postoperative complications.
- Further research may be needed to fully elucidate the comparative benefits of LA for CA.
