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Laparoscopic appendectomy does not change the incidence of postoperative infectious complications
A Klingler1, K P Henle, S Beller
1Department of General Surgery II, University of Innsbruck, Austria.
Background:
It is not clear whether the laparoscopic approach does decrease the incidence of postoperative infectious complications after appendectomy.
Methods:
One hundred sixty-nine patients were randomized, 87 with laparoscopic (LA) and 82 with open appendectomy (OA). Patients in the OA group had a McBurney incision; LA was performed in the lithotomy position.
Results:
Acute appendicitis was confirmed in 75% of patients. The appendix was perforated in 5 patients of the LA versus 2 patients of the OA group. No conversion to the open procedure was necessary. The median operating time was 35 minutes in the LA group and 31 minutes in the open group (P = 0.58). The median postoperative hospital stay was shorter after laparoscopic than after open surgery (3 days versus 4 days, P = 0.026), whereas the time required for return to work was not significantly different (14 versus 15 days). There were 5 (6%) patients with superficial wound infection following LA and 6 (7%) after OA (P = 0.67). Intra-abdominal fluid collections were found in 2 (2%) patients following LA and 3 (4%) patients following OA (P = 0.60). In the LA group, 3 patients presented with intra-abdominal hemorrhage and another 3 developed a paralytic ileus that was treated conservatively.
Conclusions:
Laparoscopic appendectomy is as safe and as effective as the open procedure; however, it does not decrease the rate of postoperative infectious complications.
Insights
Laparoscopic appendectomy is as safe as open surgery, but does not reduce infectious complications. This study compared outcomes for 169 patients undergoing either procedure for appendicitis.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- The efficacy of laparoscopic appendectomy in reducing postoperative infectious complications remains unclear.
- Appendectomy is a common surgical procedure with varying approaches.
Purpose of the Study:
- To compare the incidence of postoperative infectious complications between laparoscopic appendectomy (LA) and open appendectomy (OA).
- To evaluate the safety and effectiveness of LA versus OA in patients with acute appendicitis.
Main Methods:
- A randomized controlled trial involving 169 patients (87 LA, 82 OA).
- Standardized surgical techniques were used for both groups.
- Data on operating time, hospital stay, return to work, and complications were collected.
Main Results:
- No significant difference in the rate of superficial wound infections (6% LA vs. 7% OA) or intra-abdominal fluid collections (2% LA vs. 4% OA).
- Laparoscopic appendectomy resulted in a shorter median postoperative hospital stay (3 days vs. 4 days, P=0.026).
- Operating time and time to return to work were not significantly different between the groups.
Conclusions:
- Laparoscopic appendectomy is a safe and effective alternative to open appendectomy.
- The laparoscopic approach does not offer a significant advantage in reducing postoperative infectious complications compared to the open procedure.