Laparoscopic versus open surgery for suspected appendicitis.

Area of Science:

• Surgical Procedures
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Appendectomy is a common surgical procedure for acute appendicitis.
• Open appendectomy (OA) has been the standard treatment.
• Laparoscopic appendectomy (LA) offers a minimally invasive alternative.

Purpose of the Study:

• To compare the benefits and harms of laparoscopic appendectomy (LA) versus open appendectomy (OA).

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing LA and OA.
• Searched multiple databases up to February 2018.
• Included 85 RCTs with 9765 participants (adults and children).

Main Results:

• In adults, LA reduced pain, wound infections, hospital stay, and time to normal activity, but increased intra-abdominal abscesses.
• In children, LA reduced wound infections and hospital stay.
• Evidence quality ranged from low to moderate, with some clinical effects being small.

Conclusions:

• LA offers advantages over OA in adults for several outcomes, despite a higher risk of intra-abdominal abscesses.
• LA shows benefits in wound infections and hospital stay for children.
• Further high-quality research is needed, especially on quality of life in children.