Laparoscopic Versus Open Appendectomy for Complicated Appendicitis

Yau, Kwok Kay; Siu, Wing Tai; Tang, CN; Yang, George Pei Cheung; Li, Michael Ka Wah

doi:10.1016/j.jamcollsurg.2007.03.017

Cited by 183 publications

(139 citation statements)

References 41 publications

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“…Hence it is the choice of surgeons to decide whether to go for laparoscopic appendectomy or open appendectomy. 4 Use of Laparoscopic appendectomy technique in cases of complicated appendicitis remains doubtful. 5 Considering pros and cons discussed above, laparoscopic appendicectomy is suggested as the method of choice for surgical treatment for acute appendicitis.…”

Section: Introductionmentioning

confidence: 99%

Study of laparoscopic appendectomy: advantages, disadvantages and reasons for conversion of laparoscopic to open appendectomy

2017

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Background:Good outcome has been reported with the laparoscopic approach in uncomplicated appendicitis, but a higher incidence of postoperative intraabdominal abscesses has been reported after laparoscopic appendectomy in complicated appendicitis. Objective was to study the efficacy of laparoscopic appendectomy.Methods: A Hospital based cross sectional study was carried out among of 302 patients. The study duration was from June 2004 to December 2006. Institutional Ethics Committee permission was obtained. Informed individual consent was taken. Out of 302 subjects, 236 underwent open appendectomy and 66 underwent laparoscopic appendectomy.Results:It was observed that in both the groups majority patients had retrocecal position of the appendix. The amount of blood loss, adjacent organ injury and duration of surgery were similar in both the groups. The difference in the incidence of wound infection in both groups was not found to be statistically significant. But the antibiotic use was significantly less in the LA group compared to OA group. It was found that time to resumptions of oral fees, duration of hospital stay and time to return to normal duties were significantly lesser in LA group compared to OA group. (p < 0.001). As per the cosmetic end result, majorities were satisfied in LA group and rated the surgery as excellent as compared to patients in OA group.Conclusions:Laparoscopic appendectomy was better than open appendectomy with respect to wound infection, tackling co-existing pathology, duration of hospital stay, earlier return to normal activity, excellent cosmetic end result, lesser use of antibiotics and earlier resumption of oral feeds.

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Section: Introductionmentioning

confidence: 99%

Study of laparoscopic appendectomy: advantages, disadvantages and reasons for conversion of laparoscopic to open appendectomy

2017

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“…Many previous reports comparing LA and OA did not analyze readmission rates [9][10][11]. The hospital stay of LA was 5 days in our study and less than 7 days in most other studies [10][11][12]. Taking account of the fact that IAA usually develops 7 to 10 days after surgery, late development of IAA can be missed if readmission is not analyzed during the data review period, especially in a retrospective study.…”

Section: Discussionmentioning

confidence: 52%

Comparison of Surgical Infection and Readmission Rates after Laparoscopy in Pediatric Complicated Appendicitis

Boo

Lee

et al. 2014

J Korean Assoc Pediatr Surg

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Purpose: Laparoscopic appendectomy (LA) has become a gold standard for children even in complicated appendicitis. The purpose of this study was to compare the postoperative surgical site infection rates between laparoscopic and open appendectomy (OA) group in pediatric complicated appendicitis. Methods: A total of 1,158 pediatric patients (age ≤15 years) underwent operation for appendicitis over a period of 8 years. Among these patients, 274 patients (23.7%) were diagnosed with complicated appendicitis by radiologic, operative and pathologic findings, and their clinical outcomes were retrospectively analyzed. Results: Of the 274 patients with complicated appendicitis, 108 patients underwent LA and 166 patients underwent OA. Patients in the LA group returned to oral intake earlier (1.9 days vs. 2.7 days; p＜0.01) and had a shorter hospital stay (5.0 days vs. 6.3 days; p＜0.01). However, rate of postoperative intra-abdominal infection (organ/space surgical site infection) was higher in the LA group (LA 15/108 [13.9%] Conclusion:The minimally invasive laparoscopic technique has more advantages compared to the open procedure in terms of hospital stay and early recovery. However, intra-abdominal infection and readmission rates were higher in the laparoscopy group. Further studies should be performed to evaluate high rate of organ/space surgical infection rate of laparoscopic procedure in pediatric complicated appendicitis.

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“…The current literature demonstrates conflicting evidence with some studies suggesting that LA is associated with a higher risk of developing pelvic sepsis, 13,14,18,22 and other studies concluding that this is not significant. 8,[10][11][12]16,19,21 Our study reports 19 patients with pelvic sepsis (laparoscopic n = 2, open n = 17) demonstrating no statistically significant difference in pelvic sepsis between the two operative groups (p = 0.1184). Although there was no significant difference, LA was associated with a decreased risk of pelvic sepsis.…”

Section: Discussionmentioning

confidence: 66%

“…9 Since that time the advantages of the laparoscopic technique have been well demonstrated and Laparoscopic Appendicectomy (LA) has become the preferred procedure over OA in hospitals worldwide. [10][11][12][13][14][15] Advantages of LA include reduced postoperative pain and cosmesis. 8,12,[14][15][16][17][18][19][20][21] Despite the popularity of LA, it is still a controversial subject and some studies demonstrate a preference towards OA.…”

Section: Introductionmentioning

confidence: 99%

“…8,[10][11][12]16,19,21 A study by Sleem et al suggests that LA is safe to use in cases of perforated appendicitis with no evidence of increased rate of postoperative pelvic collection when compared with OA. 12 Another study reports that LA should decrease the incidence of pelvic sepsis as the procedure allows better visualisation of the abdominal cavity and a thorough washout of all abdominal quadrants.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pelvic sepsis following laparoscopic appendicectomy versus open appendicectomy: a retrospective study of 648 cases

Adams

Jaunoo

2015

Int Surg J

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Laparoscopic Versus Open Appendectomy for Complicated Appendicitis

Cited by 183 publications

References 41 publications

Study of laparoscopic appendectomy: advantages, disadvantages and reasons for conversion of laparoscopic to open appendectomy

Study of laparoscopic appendectomy: advantages, disadvantages and reasons for conversion of laparoscopic to open appendectomy

Comparison of Surgical Infection and Readmission Rates after Laparoscopy in Pediatric Complicated Appendicitis

Pelvic sepsis following laparoscopic appendicectomy versus open appendicectomy: a retrospective study of 648 cases

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