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Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
762

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Should appendectomy be performed laparoscopically? Clinical prospective randomized trial.

Barış Mantoğlu1, Bora Karip2, Metin Mestan3

  • 1Clinic of General Surgery, Afşin State Hospital, Kahramanmaraş, Turkey.

Ulusal Cerrahi Dergisi
|December 16, 2015
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Summary

Laparoscopic appendectomy (LA) offers reduced pain and faster recovery compared to open appendectomy (OA) for acute appendicitis. This study found LA to be effective and potentially more cost-effective.

Keywords:
Acute appendicitislaparoscopic appendectomyopen appendectomy

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Area of Science:

  • General Surgery
  • Minimally Invasive Surgery

Background:

  • The superiority of laparoscopic appendectomy (LA) over open appendectomy (OA) for acute appendicitis remains debated.
  • While LA is often associated with reduced postoperative pain and quicker return to normal activities, evidence is conflicting.

Purpose of the Study:

  • To compare the clinical outcomes and cost-effectiveness of LA and OA in patients with acute appendicitis.

Main Methods:

  • A prospective randomized study comparing LA (31 patients) and OA (32 patients).
  • Data collected included demographics, inflammatory markers (CRP, WBC), operative time, hospitalization duration, complications, pain scores (VAS), and costs.
  • Return to normal activities was assessed via phone calls at 1 week, 2 weeks, and 1 month post-surgery.

Main Results:

  • Laparoscopic appendectomy showed a significant postoperative decrease in white blood cell count (p<0.01).
  • No significant differences were observed in postoperative C-reactive protein levels or complication rates (wound infection, abscess) between the groups.
  • Patients undergoing LA reported significantly lower postoperative pain and a faster return to normal activities compared to OA (p<0.01).
  • Operative time in the LA group correlated positively with body mass index (BMI), unlike in the OA group.
  • Average costs were substantially higher for LA (1960.5±339.05 TL) compared to OA (687.115±159.5 TL).

Conclusions:

  • Laparoscopic appendectomy is an effective treatment for acute appendicitis, characterized by reduced pain and accelerated recovery.
  • LA may be the preferred surgical approach for acute appendicitis, especially with the use of cost-effective vascular sealing devices.