Konventionelle oder laparoskopische Operation der perforierten Appendizitis - Eine vergleichende Studie

Kapischke, Matthias; Bley, K.; Tepel, Juergen; Schulz, Therese

doi:10.1055/s-2005-836411

Cited by 9 publications

(4 citation statements)

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“…A relatively small number of cases were done during the study time period and this is part of the surgeons' learning curve where the complications and conversions tend to be relatively higher. A conversion rate of up to 9% has been reported in busy high volume hospitals with laparoscopic appendicectomy [24,25]. Complications included spinal headache which was 2.6% in all the laparoscopic procedures which was comparable to that found in other studies.…”

Section: Discussionsupporting

confidence: 68%

Laparoscopic Surgery in a Developing Country in East Africa: An Audit at the Initial Part of a Surgeons’ Learning Curve

Wismayer

2020

JAMMR

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Background: In many surgical conditions, laparoscopic surgery has been used for surgical access. In the West, laparoscopic cholecystectomy is the gold standard treatment for cholecystitis. On the other hand controversy has been generated with laparoscopic appendicectomy due to the cost, time consuming nature of the procedure, together with many trocar sites which in all approximate to the length of an open appendicectomy incision. The purpose of this study is to audit the initial laparoscopic units experience in a developing country in East Africa. Methods: This was a retrospective study conducted in the Department of Surgery. All patients that consented to laparoscopic cholecystectomy and laparoscopic appendicectomy over the initial period of 13 months were included in this study. Results: A total of thirty (30) patients consented to having laparoscopic surgery; Ten (10) patients consented to laparoscopic cholecystectomies with a male:female ration of 1:2.33 and twenty (20) patients consented to laparoscopic appendicectomies with a male:female ratio of 1:1.2. The mean operating time was 58.5 minutes for laparoscopic cholecystectomy and 40.45 minutes for laparoscopic appendicectomy. The duration of post-operative admission ranged from 3 days to 5 days with a mean duration of 4.2 days for laparoscopic cholecystectomy and from 2 days to 5 days with a mean of 2.65 days for laparoscopic appendicectomy. No complications were reported apart from spinal headache in 2 patients (2.6%) out of the total laparoscopic procedures. There were no readmissions over the one month of follow up. Conclusions: Laparoscopic cholecystectomy and laparoscopic appendicectomy allows for early discharge and is safe. In Uganda, the low incidence of cholecystitis compared to the higher incidence of appendicitis, supports the adoption of laparoscopic appendicectomy compared to cholecystectomy for hand and eye coordination training. The surgeons’ initial cases of laparoscopic procedures have demonstrated an adequate level of safety which supports laparoscopic appendicectomy to acquire the basic laparoscopic surgery skills.

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Section: Discussionsupporting

confidence: 68%

Laparoscopic Surgery in a Developing Country in East Africa: An Audit at the Initial Part of a Surgeons’ Learning Curve

Wismayer

2020

JAMMR

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“…[151][152][153][154][155][156] However, the conversion rate then increases up to 47%. Kapischke et al 157 found a conversion rate of only 2.5%, indicating that the experience of the surgeon plays an important role in this discussion. Operative success in complicated appendicitis depends on the following: diligent intraabdominal lavage (especially the pouch of Douglas, subhepatic and subphrenic spaces on the right side), placement of the drain in the lowest point in Douglas's space for both drainage (Easyflow) and postoperative lavage, and safe removal of the appendix.…”

Section: Appendectomymentioning

confidence: 89%

Laparoscopic Surgery—15 Years After Clinical Introduction

Bittner

2006

World j. surg.

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“…Auch diese sieben Appendices wiesen im präoperativen Ultraschall alle Zeichen einer akuten Appendizitis ohne sicheren Nachweis einer Perforation auf. Die SPA ließ sich auch in diesen Fällen problemlos durchführen, wie in der Literatur im Falle der LA mehrfach beschrieben wird [16,18,38]. Einschränkend ist anzumerken, dass diese sieben perforierten Appendices makroskopisch eine beginnende Perforation aufwiesen.…”

Section: Perforierte Appendizitisunclassified

Laparoskopische „Single Port“-Appendektomie im Kindesalter

Sesia

Frech²,

Häcker³

et al. 2010

Zentralbl Chir

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Konventionelle oder laparoskopische Operation der perforierten Appendizitis - Eine vergleichende Studie

Abstract: Laparoscopic appendectomy is a safe procedure for the treatment of complicated appendicitis with a significantly decreased complication rate and shorter postoperative stay.

Cited by 9 publications

References 4 publications

Laparoscopic Surgery in a Developing Country in East Africa: An Audit at the Initial Part of a Surgeons’ Learning Curve

Laparoscopic Surgery in a Developing Country in East Africa: An Audit at the Initial Part of a Surgeons’ Learning Curve

Laparoscopic Surgery—15 Years After Clinical Introduction

Laparoskopische „Single Port“-Appendektomie im Kindesalter

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