Does Laparoscopic Appendectomy Impart an Advantage over Open Appendectomy in Elderly Patients?

Masoomi, Hossein; Mills, Steven; Dolich, Matthew; Ketana, Noor; Carmichael, Joseph C.; Nguyen, Ninh T.; Stamos, Michael J.

doi:10.1007/s00268-012-1545-9

Cited by 42 publications

(34 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The overall complication rates were significantly lower in LA group as compared to open appendicectomy (OA) group (36.27 % (LA) vs. 46.92 % (OA) p<0.01) [14]. In pregnant patients undergoing LA, there is conflicting evidence with regard to increased foetal loss and preterm labour.…”

Section: Appendicitismentioning

confidence: 92%

See 1 more Smart Citation

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

et al. 2014

View full text Add to dashboard Cite

Laparoscopy has already established itself as the preferred surgical approach in a variety of elective surgical conditions. Along with its usual advantages of less tissue trauma and faster recovery, its diagnostic as well as therapeutic role is making it an attractive option in emergency surgery. In this paper, we have reviewed the current status of laparoscopic surgery in luminal gastrointestinal emergencies. Relevant papers were selected using Medline database from 2007 to the present. These were reviewed, and outcomes were stated under the headings of appendicitis, perforated peptic ulcer, colorectal emergencies and small bowel obstruction. The laparoscopic intervention was found to be of clear benefit in most of the patients with appendicitis. Its role, however, is not absolutely clear in managing perforated peptic ulcers. Laparoscopic lavage and drainage have been recommended in diverticular perforation with limited contamination. Small case series and studies have shown benefits of laparoscopic surgery in iatrogenic colonic perforations, colonic obstruction, emergency colectomy and small bowel obstruction. Laparoscopic surgery can be recommended in appendicitis and lowrisk cases of perforated peptic ulcers. Its definitive role in other conditions needs more evidence. The surgeon's experience and careful patient selection are very important to improve the outcome.

show abstract

Section: Appendicitismentioning

confidence: 92%

“…Laparoscopic appendicectomy has been found to be feasible and potentially safe in the elderly (>65 years) with no increase in morbidity [14]. The overall complication rates were significantly lower in LA group as compared to open appendicectomy (OA) group (36.27 % (LA) vs. 46.92 % (OA) p<0.01) [14].…”

Section: Appendicitismentioning

confidence: 99%

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

et al. 2014

View full text Add to dashboard Cite

show abstract

“…postoperative intestinal obstruction, nausea, vomiting, pancreatitis or complications associated with the anastomosis of the gastrointestinal tract (11% vs 9.6%) (17). Most of the complications, assessed in terms specified by the authors, occurred in patients undergoing open appendectomy surgery (9,11,13,17). The observation time in the majority of cases (6/10 works), however, did not go beyond the duration of hospitalization, which could have affected the results of the information collected due to underestimation of the number of complications and mortality.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Operative complications, which were taken into account most frequently, were the following: surgical site infection (9,(11)(12)(13)(14)(15)17), complications of the respiratory system (9,11,12,13,15,17), urinary tract infection (9,11,13,15,17), abscesses or intra-abdominal infections (9, 11), wound dehiscence (9), acute renal failure (9,11,13), intestinal obstruction (9,11,15). In the individual studies, the most commonly observed were: wound infection (OA vs LA: 3.8% vs 1.4% (9); 5.9% vs 2.2% (13); 5.7% vs 0 (12); 8.6% vs 4.2% (14), postoperative intestinal obstruction (10.76% vs 7.3%) (11), gastrointestinal complications, i.e.…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Four out of ten works show that patients with fewer comorbidities were qualified for laparoscopic surgery (9,11,13,17). These patients were significantly less frequently diagnosed with lung disease (9,11,13), renal disease/ failure (9, 11, 13), liver disease (11, 13), peripheral vascular disease (9), congestive heart failure (11,17) or hypertension (11). High body mass index was qualified as preoperative contraindication in some cases (2/10 works): both of these works showed no statistically significant differences between the OA vs LA groups when comparing the mean BMI±SD: 27±6.4 vs 27.6±5.8; p=0.688 (9) and 27.6±6.5 vs 27.6±5.6; p=0.8289 (13).…”

Section: Surgical Treatmentmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Acute Appendicitis in Geriatric Patients – Literature Review

Kоt¹,

Kenig²,

Wałęga³

2016

Polish Journal of Surgery

View full text Add to dashboard Cite

Demographic changes associated with the aging population mean that surgeons increasingly have contact and make decisions about treating patients from the oldest age groups. the aim of the study was to review the literature concerning the treatment of acute appendicitis in patients over the age of 60 years old. material and methods. A review of the literature published in the years 2000-2015 has been carried out using the PubMed database. The initial number of results corresponding to the query in English, "appendicitis (MeSH) AND elderly (MeSH)" was 260. Selection based on the titles, abstracts, and eventually whole articles, ultimately resulted in 11 papers concerning the treatment of appendicitis in patients above 60 years of age. Results. Nine papers were retrospective and 2 were prospective. In total, the studies included 82,852 patients. Laparoscopic appendectomy was associated with a lower mortality rate, a smaller number of postoperative complications and a shorter length of hospital stay, which led to it being recommended by most authors. Four of the ten papers demonstrated that the patients who were qualified for laparoscopic surgery had less comorbidity and were in a lower ASA (American Society of Anaesthesiology) category. Antibiotic therapy as an independent method was assessed in one study in a group of elderly people, on a selected group of 26 patients, and its effectiveness was shown to be 70%. Most studies, however, are highly heterogeneous which significantly hindered comparisons. conclusions. Currently, laparoscopic appendectomy seems to be the treatment of choice in the elderly with acute appendicitis. Antibiotic therapy, as an independent method of treatment of acute appendicitis, cannot currently be recommended. However, further, prospective, and better-designed studies are needed, involving a larger number of patients, and primarily dedicated to the elderly.

show abstract

Laparoscopic vs Open Appendectomy in Older Patients

Southgate¹,

Vousden²,

Karthikesalingam³

et al. 2012

Arch Surg

View full text Add to dashboard Cite

show abstract

Does Laparoscopic Appendectomy Impart an Advantage over Open Appendectomy in Elderly Patients?

Abstract: Laparoscopic appendectomy can be performed safely with significant advantages compared with open appendectomy in the elderly and should be considered the procedure of choice for perforated and nonperforated appendicitis in these patients.

Cited by 42 publications

References 26 publications

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

Laparoscopic Surgery in Luminal Gastrointestinal Emergencies—a Review of Current Status

Treatment of Acute Appendicitis in Geriatric Patients – Literature Review

Laparoscopic vs Open Appendectomy in Older Patients

Contact Info

Product

Resources

About