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Laparoscopic versus open appendectomy: a metaanalysis

R Golub1, F Siddiqui, D Pohl

  • 1Department of Surgery, The New York Flushing Hospital, 11355, USA.

Journal of the American College of Surgeons
|May 16, 1998
PubMed
Summary
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Laparoscopic appendectomy (LA) offers significant advantages over open appendectomy (OA), including reduced pain, faster recovery, and fewer wound infections. Further research is needed on the increased risk of intraabdominal abscesses with LA.

Area of Science:

  • Surgical Innovation
  • Gastrointestinal Surgery
  • Minimally Invasive Procedures

Background:

  • Numerous studies exist on laparoscopic appendectomy (LA) versus open appendectomy (OA).
  • Controversy persists regarding the superiority of LA over OA.
  • Previous research includes retrospective series and 16 prospective randomized studies.

Purpose of the Study:

  • To clarify the superiority of LA over OA.
  • To perform a meta-analysis of randomized prospective studies comparing LA and OA.

Main Methods:

  • Meta-analysis of all formally randomized prospective trials.
  • Comparison of laparoscopic appendectomy (LA) versus open appendectomy (OA) in adults.

Main Results:

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  • LA significantly reduces postoperative pain, shortens hospital stays, and speeds return to normal activities.
  • Wound infection rates are less than half in LA compared to OA.
  • LA has longer operating times and a trend towards higher intraabdominal abscess rates, though not statistically significant.

Conclusions:

  • Laparoscopic appendectomy (LA) provides significant benefits over open appendectomy (OA), notably reduced wound infections and faster recovery.
  • Widespread adoption of LA is recommended.
  • The increased incidence of intraabdominal abscesses with LA warrants further investigation.