Laparoscopic appendicectomy is associated with a lower complication rate even during the introductory phase

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

doi:10.1007/s00423-004-0511-x

Cited by 10 publications

(7 citation statements)

References 32 publications

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“…Details of the study design have been described previously [12]. Briefly, from 1999 to 2001, 493 patients with the clinical diagnosis of suspected acute appendicitis were operated at the same general district hospital and assessed retrospectively.…”

Section: Methodsmentioning

confidence: 99%

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Laparoscopic versus open appendectomy—quality of life 7 years after surgery

Kapischke

Friedrich²,

Hedderich

et al. 2010

Langenbecks Arch Surg

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Section: Methodsmentioning

confidence: 99%

“…Comparison of grade of inflammation showed no differences in both groups. More details about both groups are available in [12].…”

Section: Operating Proceduresmentioning

confidence: 99%

Laparoscopic versus open appendectomy—quality of life 7 years after surgery

Kapischke

Friedrich²,

Hedderich

et al. 2010

Langenbecks Arch Surg

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“…In case of related obstruction, bowel manipulation for exploration may be difficult or dangerous and is associated with a conversion. This failure ranges between 2% [13] and 5% [6,7]. Sometimes, when the surgical team is not used to making a regular laparoscopic approach for acute abdomen, laparoscopy may be ineffective.…”

Section: Appendix Staplingmentioning

confidence: 99%

“…Laparoscopic management of acute appendicitis is exceptionally associated with specific related complications. In 2012, its conversion rate ranged between 0 and 5% [6,7], and was mainly linked to associated small bowel functional obstruction or adhesions due to previous surgical procedures, and exceptionally to morbidity directly associated with the laparoscopic approach. It appears to be significantly lower as compared to OA [1,5].…”

Section: Acute Appendicitis: Laparoscopic Approachmentioning

confidence: 99%

“…However, thanks to the greater experience of many surgeons, as well as to the availability of high-quality laparoscopic material which have been available in emergency settings since 2000, the drawback of LA in comparison to OA is no longer as pronounced, as LA duration is described as lasting between 35 and 40 min [6,12]. …”

Section: Acute Appendicitis: Laparoscopic Approachmentioning

confidence: 99%

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Appendicitis/Diverticulitis: Minimally Invasive Surgery

Mutter

Marescaux

2013

Dig Dis

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Complicated intra-abdominal infections such as acute appendicitis and complicated diverticulitis represent both diagnostic and therapeutic challenges. Both diseases, although different in many ways, are caused by the obstruction of a blind pouch leading to inflammation, abscesses, and perforation of surrounding tissues. For many decades, acute appendicitis was managed through a conventional surgical incision in the right iliac fossa. As for other diseases, there is a significant tendency to propose less invasive treatments. For many teams, laparoscopy, which leads to less postoperative pain, a shorter hospital stay, and a quicker recovery, represents the standard of care for appendectomy. For selected cases, a medical approach can be proposed with satisfactory outcomes. Additionally, the management of complicated diverticulitis is also quickly moving towards less invasive procedures than the deleterious ‘3-phase surgery', which is Hartmann's procedure, followed by reversal protected with a stoma, and finally stoma closure. Benefiting from the evolution of antimicrobial therapy and interventional radiology, many complicated cases classified as Hinchey stage I and Hinchey stage II complicated diverticulitis are now treated medically. CT images allow the identification of patients requiring radiological drainage of localized abscesses or collections over 5 cm in size. Patients with Hinchey stage III sigmoiditis may benefit from an initial laparoscopic exploration allowing, in some cases, a conservative nonresective approach that will prevent laparotomy and stoma. Major resection leading to temporary or definitive stoma is usually indicated for stage IV complications and is required only in exceptional cases. Although a surgical intervention can be the definitive treatment for complicated intra-abdominal infections, multidisciplinary management including radiology, medical treatment, and laparoscopic surgery may limit the severe consequences of an acute surgical approach in patients suffering from complicated appendicitis and diverticulitis. Today, the ultimate goal of acutely infected abdomen management is to reduce hospital stay, disability, and numerous operations for these patients.

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