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Comparison of Laparoscopic and Open Surgery for Appendiceal Mucocele in Terms of Safety and Feasibility
Mustafa Yılmaz1, Mahsum Barçin1, Zafer Can Kesikminare2
1Department of Surgical Oncology, Mersin University Faculty of Medicine, Mersin, Turkey. (Drs. Yılmaz and Barçin).
Objectives:
Appendiceal mucocele (AM) is a rare clinicopathological entity, and the optimal surgical approach remains controversial because of concerns regarding intraoperative rupture and mucin spillage. This study aimed to compare laparoscopic surgery (LS) and open surgery (OS) in patients with AM in terms of perioperative safety, postoperative recovery, and pathological outcomes.
Methods:
This retrospective single-center study included 53 patients who underwent surgery for AM between January 2010 and January 2026. Patients were divided into LS and OS groups. Demographic and clinical characteristics, operative findings, postoperative outcomes, and histopathological results were compared between the groups.
Results:
Of the 53 patients, 20 underwent LS and 33 underwent OS. Baseline clinical characteristics were generally comparable between the groups, although female sex was more frequent in the LS group. Operative time, surgical procedure distribution, intraoperative perforation findings, intraoperative mucocele rupture, Clavien-Dindo scores, morbidity, readmission, and reoperation rates were not significantly different between the groups. LS was associated with earlier return of bowel function, earlier tolerance of a soft diet, and shorter postoperative hospital stay. Low-grade appendiceal mucinous neoplasm was the most common histopathological diagnosis, and pathological diagnosis distribution and surgical margin positivity were comparable between the groups.
Conclusion:
LS may be considered a safe and feasible alternative to OS in selected patients with AM, providing comparable perioperative and pathological outcomes with more favorable short-term postoperative recovery. Careful patient selection, meticulous surgical technique, and readiness for conversion remain essential.
Insights
Laparoscopic surgery (LS) offers a safe alternative to open surgery (OS) for appendiceal mucocele (AM), with similar safety and pathology outcomes but faster recovery. Careful patient selection is key for successful LS in AM treatment.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Appendiceal mucocele (AM) is a rare condition with debated surgical management due to rupture risks.
- Laparoscopic surgery (LS) and open surgery (OS) are potential approaches for AM.
Purpose of the Study:
- To compare the perioperative safety, postoperative recovery, and pathological outcomes of LS versus OS for appendiceal mucocele.
Main Methods:
- A retrospective single-center study analyzed 53 patients with AM, comparing outcomes between LS (n=20) and OS (n=33).
- Data included demographics, operative findings, recovery metrics, and histopathology.
Main Results:
- No significant differences were found in operative time, intraoperative rupture, or complication rates (Clavien-Dindo scores) between LS and OS.
- Laparoscopic surgery was associated with earlier return of bowel function, diet tolerance, and shorter hospital stays.
- Histopathological diagnoses and surgical margin positivity were comparable between the groups.
Conclusions:
- Laparoscopic surgery is a safe and feasible option for selected appendiceal mucocele patients, offering improved short-term recovery.
- Meticulous surgical technique, patient selection, and readiness for conversion are crucial for successful laparoscopic appendiceal mucocele treatment.
