[Retrospective comparative study of 600 appendectomies carried out by laparotomy (Mac Burney) or laparoscopy. A plea...

The authors report the results of a retrospective study comparing 305 appendectomies by laparotomy (performed in 1988-1989) with 295 appendectomies by laparoscopy (1990-1991). The appendectomy was performed by the "out" technic in 98% of cases of laparoscopy. The two populations are similar. There was no mortality. There was 1% of conversion, 1.4% of incidents and no major accident after laparoscopy. The post-operative course was smooth in 88.2% of cases after laparotomy and in 98% after laparoscopy. A treatment for pain was necessary in 98% of cases after laparotomy and only 45.4% after laparoscopy. The rates of parietal complications, intra-abdominal complications and reinterventions were respectively 10.8%, 1% and 2.4% after laparotomy and 0%, 2.4% and 2.4% after laparoscopy. The mean hospital stay was 7 days after laparotomy and 4 days after laparoscopy. In conclusion, laparoscopy appears superior to laparotomy for performance of an appendectomy: it allows better abdominal exploration, more simple and shorter post-operative course and suppresses parietal complications provided that it is performed by a surgeon with great experience of laparoscopy and respects classic principles of digestive surgery.