Laparoscopic treatment of perforated appendicitis

Abstract

The use of laparoscopy has been established in improving perioperative and postoperative outcomes for patients with simple appendicitis. Laparoscopic appendectomy is associated with less wound pain, less wound infection, a shorter hospital stay, and faster overall recovery when compared to the open appendectomy for uncomplicated cases. In the past two decades, the use of laparoscopy for the treatment of perforated appendicitis to take the advantages of minimally invasiveness has increased. This article reviewed the prevalence, approaches, safety disclaimers, perioperative and postoperative outcomes of the laparoscopic appendectomy in the treatment of patients with perforated appendicitis. Special issues including the conversion, interval appendectomy, laparoscopic approach for elderly or obese patient are also discussed to define the role of laparoscopic treatment for patients with perforated appendicitis.

Laparoscopic versus open surgery for complicated appendicitis in adults: a randomized controlled trial

“…The surgical management of CA generally requires a larger abdominal incision and longer operating time, with increased surgical stress to patients, compared Values are mean ± SD with surgery for uncomplicated appendicitis. The effectiveness of the laparoscopic approach for CA has been extensively studied [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. However, the role of laparoscopy in CA is still undefined due to lack of high-level evidence (e.g., randomized controlled trials).…”

“…On the other hand, postoperative intraabdominal abscess (IAA) remains a major concern in LA for perforated appendicitis. Indeed, the reported rate of postoperative IAAs diverges widely in different studies comparing LA versus open appendectomy (OA) for CA [1][2][3][5][6][7][8][9][10][11][12][13][14][15].These previous retrospective reports provide the initial framework for higher-level studies on LA versus OA for CA, and randomized controlled trials evaluating the laparoscopic approach for CA are warranted [16]. We designed this randomized controlled study to investigate whether LA for CA effectively reduces the incidence of postoperative complications and improves various measurements of postoperative recovery in adults compared with OA.…”

“…Recent studies, including retrospective analyses of large databases or meta-analyses, showed that laparoscopic appendectomy (LA) is associated with a reduction in wound infection rates and in-hospital stays as well as less postoperative pain with quicker functional recovery [1][2][3][4][5][6]. On the other hand, postoperative intraabdominal abscess (IAA) remains a major concern in LA for perforated appendicitis.…”

“…On the other hand, postoperative intraabdominal abscess (IAA) remains a major concern in LA for perforated appendicitis. Indeed, the reported rate of postoperative IAAs diverges widely in different studies comparing LA versus open appendectomy (OA) for CA [1][2][3][5][6][7][8][9][10][11][12][13][14][15].…”

Therapeutic Consideration of Periappendiceal Abscess: an Evaluation of Non-surgical Treatment Followed by Minimally Invasive Interval Appendectomy

“…The success of laparoscopic IA has been reported without perioperative morbidity and the percentage of IA procedures that included laparoscopically has markedly increased in recent years from 30% to 85%. 3,[24][25][26] This trend will certainly make it possible to maximize the advantages of laparoscopic surgery for PAA. The advantages include fewer wound infections, less postoperative pain, shorter hospital stay, quicker recovery, and quicker return to normal activities.…”