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Randomized controlled trial with sequential design of laparoscopic versus conventional appendicectomy
O Reiertsen1, S Larsen, E Trondsen
1Department of Surgery, Akershus Central Hospital, Nordbyhagen, Norway.
The British Journal of Surgery
|June 1, 1997
Summary
Laparoscopic appendicectomy is as effective as conventional surgery for appendicitis. This minimally invasive approach significantly reduces unnecessary procedures and misdiagnosis rates, improving patient outcomes.
Area of Science:
- Surgical innovation in emergency medicine.
- Comparative effectiveness research in general surgery.
Background:
- Prospective evaluation of 272 patients with suspected appendicitis.
- Assessing study group representativity and comparing surgical techniques.
Purpose of the Study:
- To compare diagnostic and therapeutic laparoscopy with conventional appendicectomy.
- To evaluate the representativity of the study cohort.
Main Methods:
- Open, randomized, single-centre trial with sequential design.
- 108 patients randomized (84 with acute appendicitis) between laparoscopy and conventional appendicectomy.
- Primary endpoint: duration of postoperative convalescence.
Main Results:
- Laparoscopic appendicectomy significantly reduced the risk of unnecessary procedures (P=0.03).
- Shorter convalescence (4.7 days) favored laparoscopy (P=0.07), while conventional surgery was faster (26 min, P<0.01).
- No significant differences in hospital stay, pain, or complications.
Conclusions:
- Laparoscopic appendicectomy is a safe and effective alternative to conventional appendicectomy.
- Early laparoscopy improves diagnostic accuracy, reducing misdiagnosis rates.