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LAPAROSCOPIC APPENDICECTOMY: RISK FACTORS FOR CONVERSION TO LAPAROTOMY
Mouna Cherif1, Meryam Mesbahi1, Haithem Zaafouri1
1Habib Thameur Hospital, Visceral Surgery - Tunis, Tunisia.
Preoperative factors like comorbidities and appendicular perforation increase the risk of converting laparoscopic appendectomy to open surgery. Identifying these factors helps surgeons choose the best surgical approach for acute appendicitis.
Area of Science:
- General Surgery
- Minimally Invasive Surgery
Background:
- Laparoscopic appendectomy is the standard treatment for acute appendicitis.
- Conversion rates from laparoscopic to open surgery are key indicators of surgical skill.
Purpose of the Study:
- To identify preoperative factors predicting conversion from laparoscopic to open appendectomy.
- To guide surgical method selection for individual acute appendicitis patients.
Main Methods:
- Retrospective analysis of 725 patients with acute appendicitis.
- Patients underwent laparoscopic appendectomy, with 121 (16.7%) converted to laparotomy.
Main Results:
- Comorbidities, appendicular perforation, retrocecal appendix, gangrenous appendix, appendicular abscess, and difficult dissection significantly predicted conversion.
- Difficult dissection (OR 9.2) and appendicular perforation (OR 5.1) were strong predictors.
Conclusions:
- Laparoscopic appendectomy is a safe and advantageous procedure for acute appendicitis.
- Preoperative identification of conversion risk factors enables personalized surgical planning.
- Selecting patients for primary open appendectomy can be informed by these predictive factors.
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