Laparoscopic versus open appendectomy for complicated appendicitis in high risk patients

Werkgartner, Georg; Cerwenka, Herwig; Shabrawi, A. El; Bacher, H.; Häuser, H.; Mischinger, Hans Jörg; Wagner, Mathias; Wagner, Doris

doi:10.1007/s00384-014-2095-4

Cited by 15 publications

(17 citation statements)

References 21 publications

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“…Advanced age range was correlated with a longer evolution of the disease in several analyzes, mainly due to its atypical presentation, which leads to a late diagnosis possibly influencing the type of appendicitis at surgery, with an increase in complicated appendicitis [17][18][19][20] . In contrast to other studies, our work did not show statistical difference in the rate of complications when related to gender [20][21][22] .…”

Section: Society Of American Gastrointestinal and Endoscopiccontrasting

confidence: 99%

Fatores preditores de complicações pós-operatórias em apendicectomias.

Moreira

Garbin

Da-Natividade

et al. 2018

Rev. Col. Bras. Cir.

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RESUMO Objetivo: avaliar os principais fatores de risco para complicações pós-operatórias em pacientes submetidos à apendicectomia por apendicite aguda. Métodos: foram analisados retrospectivamente 1241 pacientes submetidos à apendicectomia aberta ou laparoscópica. Os pacientes foram alocados em quatro grupos: Grupo 1, sem complicações pós-operatórias, e Grupos 2, 3 e 4, com complicações pós-operatórias, definidas de acordo com sua gravidade, conforme classificação de Clavien-Dindo I, II e ≥III, respectivamente. Resultados: pacientes com idade ≥38,5 anos tiveram complicações mais graves (p<0,0001). Os pacientes do Grupo 1, sem complicações pós-operatórias, foram predominantemente operados por via laparoscópica. Os Grupos 2, 3 e 4 foram, em sua maior parte, operados por via convencional (p<0,0001). Razão de chances de complicações para apendicite complicada foi de 3,09, 3,04 e 12,41 para os Grupos 2, 3 e 4, respectivamente (p<0,0001). Risco anestésico, duração do procedimento e tempo de internação hospitalar estiveram relacionados com maior risco e gravidade de complicações (p<0,0001). Conclusão: os principais fatores preditores de complicações pós-operatórias em pacientes operados por apendicite aguda foram: idade ≥38,5 anos, acesso cirúrgico convencional ou aberto, apendicite complicada, ASA≥2 e tempo cirúrgico >77 minutos.

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Section: Society Of American Gastrointestinal and Endoscopiccontrasting

confidence: 99%

Fatores preditores de complicações pós-operatórias em apendicectomias.

Moreira

Garbin

Da-Natividade

et al. 2018

Rev. Col. Bras. Cir.

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“…In one study, it was reported that the risk of complications was in patients who were operated for AA increased from the age of 38.5 years, 17 and in another study complication risk was higher in patients aged 39 and older 18 . However, there was no significant difference in postoperative complications with regard to age 19 . In another study of 372 patients operated with the diagnosis of acute appendicitis, it was reported that patient age, leucocyte and CRP level, duration of the surgical operation, presence of comorbid disease, ASA score, and length of hospital stay were risk factors for the development of infectious complications in patients with complicated appendicitis.…”

Section: Discussionmentioning

confidence: 92%

Comparison of laparoscopic and open appendectomy on wound infection and healing in complicated appendicitis

Güler

Karabulut

Çalış

et al. 2020

International Wound Journal

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The aim of this study was to investigate the effects of laparoscopic and open surgery on the development of postoperative surgical wound infection and wound healing between complicated appendicitis patients. Patients with complicated appendicitis were divided into those underwent laparoscopic and open surgical procedures according to the surgical method. Patients were followed up with regard to development of any postoperative wound infection, and medical, radiological, and surgical treatment methods and results were recorded. A total of 363 patients who underwent appendectomy were examined, of which 103 (28.4%) had complicated appendicitis. Postoperative wound infection rate in patients who underwent open surgery was 15.9%, while it was 6.8% in the laparoscopic surgery group. There was no statistically significant difference between the two groups in terms of infection development rates (P > .05). The rate of surgical drainage use and rehospitalisation was significantly higher in the group with wound infection than in the group without wound infection. (P < .05). We suggest that in terms of wound infection and wound healing, laparoscopic surgery should be the method of choice for patients with complicated appendicitis. In order to reduce the frequency of wound infection, drains should not be kept for a long time in patients undergoing appendectomy.

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“…In the retrospective cohort study by Werkgartner et al investigating the benefits of LA in patients with high peri-and postoperative risk factors (ASA 3 and 4), LA was associated with slightly longer operative times and shorter hospital stay. Overall complications, graded according to the Clavien-Dindo classification, were slightly more frequent in patients after LA, whereas severe complications occurred more frequently in patients after OA [153]. For high-risk patients, LA has proven to be safe and feasible and was also associated with decreased rates of mortality, postoperative morbidity, and shorter hospitalization.…”

Section: Q44: Does Laparoscopic Single-incision Surgery Confer Any mentioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of nonoperative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and perioperative antibiotic therapy.

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Laparoscopic versus open appendectomy for complicated appendicitis in high risk patients

Abstract: Laparoscopic appendectomy can be recommended for patients with complicated appendicitis even with higher risk categories.

Cited by 15 publications

References 21 publications

Fatores preditores de complicações pós-operatórias em apendicectomias.

Fatores preditores de complicações pós-operatórias em apendicectomias.

Comparison of laparoscopic and open appendectomy on wound infection and healing in complicated appendicitis

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

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