Prolonged operative time in laparoscopic appendectomy: Predictive factors and outcomes

Area of Science:

• General Surgery
• Minimally Invasive Surgery

Background:

• Laparoscopic appendectomy is a common procedure.
• Factors influencing operative time and patient outcomes require identification.

Purpose of the Study:

• Identify preoperative predictors of prolonged operative time in laparoscopic appendectomy.
• Determine the impact of prolonged operative time on patient outcomes.

Main Methods:

• Retrospective review of 3049 laparoscopic appendectomies (2008-2014).
• Prolonged operative time defined as >90 minutes (top 10%).
• Multivariate regression analysis used to identify predictive factors and outcomes.

Main Results:

• Predictors for prolonged operative time in non-perforated appendicitis: elevated C-reactive protein, symptom duration >3 days, appendiceal diameter >10 mm.
• Predictors for prolonged operative time in perforated appendicitis: overweight, elevated C-reactive protein, symptom duration >3 days, abscess presence.
• Prolonged surgery correlated with increased complications, hospital stay, and readmission.

Conclusions:

• Key predictors of prolonged operative time include elevated C-reactive protein, symptom duration >3 days, appendiceal diameter >10 mm, and abscess.
• Prolonged operative time is associated with adverse postoperative outcomes in laparoscopic appendectomy.