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A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic Appendectomy
A E Ortega1, J G Hunter, J H Peters
1Department of Surgery, University of Southern California, Los Angeles.
American Journal of Surgery
|February 1, 1995
Summary
Laparoscopic appendectomy (LA) offers advantages over open appendectomy, including less pain and faster recovery. While operative times may be longer, LA leads to shorter hospital stays and quicker return to daily activities.
Area of Science:
- Minimally Invasive Surgery
- Gastrointestinal Surgery
- Surgical Outcomes Research
Background:
- Laparoscopic cholecystectomy is well-established, but benefits of laparoscopic appendectomy (LA) require further evaluation.
- A randomized clinical trial was conducted to assess the clinical utility of LA compared to open appendectomy (OA).
Purpose of the Study:
- To compare the outcomes of laparoscopic appendectomy (LA) using different techniques against open appendectomy (OA).
- To determine if LA offers significant advantages for patients with acute appendicitis.
Main Methods:
- A randomized clinical trial involving 253 patients diagnosed with acute appendicitis.
- Patients were assigned to three groups: LA with a linear stapler (LAS), LA with catgut ligatures (LAL), or open appendectomy (OA).
- Statistical analysis included ANOVA, Kruskal-Wallis H test, and Fisher's exact test.
Main Results:
- Laparoscopic appendectomy (LA) resulted in significantly less postoperative pain and a faster return to regular activities compared to open appendectomy (OA).
- Wound infections were less common with LA (particularly LAS) than OA.
- Patients undergoing LAS had shorter postoperative hospital stays; however, operative times were longer for both LA techniques compared to OA.
Conclusions:
- Laparoscopic appendectomy (LA) demonstrates clear advantages over open appendectomy (OA), including reduced pain and accelerated recovery.
- LA, especially the LAS technique, is associated with shorter hospital stays.
- While operative times may be slightly longer, the benefits of LA in terms of patient recovery and reduced complications support its wider clinical application.