Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness

Abstract

BackgroundAppendectomy is the most common surgical procedure performed in emergency surgery. Because of lack of consensus about the most appropriate technique, appendectomy is still being performed by both open (OA) and laparoscopic (LA) methods. In this retrospective analysis, we aimed to compare the laparoscopic approach and the conventional technique in the treatment of acute appendicitis.MethodsRetrospectively collected data from 593 consecutive patients with acute appendicitis were studied. These comprised 310 patients who underwent conventional appendectomy and 283 patients treated laparoscopically. The two groups were compared for operative time, length of hospital stay, postoperative pain, complication rate, return to normal activity and cost.ResultsLaparoscopic appendectomy was associated with a shorter hospital stay (2.7 ± 2.5 days in LA and 1.4 ± 0.6 days in OA), with a less need for analgesia and with a faster return to daily activities (11.5 ± 3.1 days in LA and 16.1 ± 3.3 in OA). Operative time was significantly shorter in the open group (31.36 ± 11.13 min in OA and 54.9 ± 14.2 in LA). Total number of complications was less in the LA group with a significantly lower incidence of wound infection (1.4 % vs 10.6 %, P <0.001). The total cost of treatment was higher by 150 € in the laparoscopic group.ConclusionThe laparoscopic approach is a safe and efficient operative procedure in appendectomy and it provides clinically beneficial advantages over open method (including shorter hospital stay, decreased need for postoperative analgesia, early food tolerance, earlier return to work, lower rate of wound infection) against only marginally higher hospital costs.Trial registrationNCT02867072 Registered 10 August 2016. Retrospectively registered.

Comparative Study of Surgical Site Infection between Laparoscopic Appendectomy and Open Appendectomy

“…The mean age difference was not statistically significant (p>0.05) between two groups. In study of Biondi et al 13 showed the mean age was found 29.66±15.13 years in OA group and 27.75±14.24 years in LA group. The mean age difference was not statistically significant (p>0.05) between two groups.…”

Laparoscopic Appendectomy as Main Therapeutic Option of Appendicitis

“…LA was usually associated a shorter hospital stay and lower incidence of wound infection. [2,3,9]. Mean operation time of LA could be similar or shorter comparing to the OA [3,9].…”

“…Laparoscopic appendectomy (LA) has been recognized as a standard procedure in the treatment of appendicitis because the procedure was associated with a shorter hospital stay and lower incidence of wound infection [1][2][3][4]. LA rate significantly increased in United State [5].…”

Laparoscopic Surgeries in Pediatric Abdominal Surgical Emergencies

“…Наиболее изученным является вопрос сравнитель-ной клинико-экономической эффективности лапароско-пической аппендэктомии по сравнению с открытой мето-дикой как у детей, так и у взрослых [83,84]. Доказано достоверное снижение длительности болевого синдрома в 2-3 раза, а значит, и затрат на обезболивание; сниже-ние количества осложнений на 70-75%, а значит, сокра-щение длительности пребывания пациента на койке, длительности послеоперационной инфузионной и анти-бактериальной терапии.…”