Laparoscopic Versus Open Appendectomy

Güller, Ulrich; Hervey, Sheleika; Purves, Harriett; Muhlbaier, Lawrence H.; Peterson, Eric D.; Eubanks, Steve; Pietrobon, Ricardo

doi:10.1097/01.sla.0000103071.35986.c1

Cited by 402 publications

(123 citation statements)

References 43 publications

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“…Gerade im Hinblick auf diese speziellen Komplika tionen variieren die Zahlen in der Litera tur [1,6,8,9,10,12,17,18,25] Die allgemeinen Komplikationen wie der postoperative paralytisch Ileus oder das passagere perioperative Nierenversa gen traten bei unseren LAPatienten häu figer auf als bei den OAPatienten. In der Literatur wird dies genau umgekehrt be schrieben.…”

Section: Tab 2 Zeitpunkt Der Appendektomie Nach Stationärer Aufnahmeunclassified

Kindliche Appendizitis

Gerstorfer

Clauer

Kistler

et al. 2011

Chirurg

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Following the first description of open appendicectomy using a lateral incision in the right lower abdomen by McBurney in 1894, this intervention was considered to be the standard method for treatment of appendicitis for nearly 100 years. In 1983 the gynecologist Semm presented a new option for the surgical therapy of appendicitis with the implementation of laparoscopic appendicectomy. Since then the indications for laparoscopic therapy have developed from young adults through elderly patients to children, pregnant women and finally to infants and newborns.

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Section: Tab 2 Zeitpunkt Der Appendektomie Nach Stationärer Aufnahmeunclassified

Kindliche Appendizitis

Gerstorfer

Clauer

Kistler

et al. 2011

Chirurg

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“…In einer US-weiten Analyse des Jahres 1997 werden 7618 (17,4%) LA mit 36.139 (82,6%) offenen Appendektomien verglichen [7]. Der Vergleich der Ergebnisse der Versorgungsforschung mit denen der Metaanalysen prospektiv randomisierter Studien zeigt eindeutig, dass die Ergebnisse der Metaanalysen nicht ohne Einschrän-kungen auf die klinische Routine über-tragen werden können.…”

Section: Ergebnisse Der Versorgungsforschungunclassified

Laparoskopische Appendektomie

Köckerling

Schug-Paß²,

Grund³

2009

Chirurg

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Since the introduction of laparoscopic appendectomy by Semm in 1983, the role of this minimally invasive surgical technique has been the focus of controversial discussion. Meta-analyses have identified its advantages as having significantly lower wound infection rates, less postoperative pain and earlier resumption of normal everyday activities. The disadvantages are higher rates of intra-abdominal abscesses, longer operating times and higher inpatient treatment costs. However, some of the advantages identified by meta-analyses have been called into question by the results obtained from research into aspects of care. These discrepancies are attributable to the different surgeons involved in the various studies. The results are greatly influenced by the qualifications and experience of the surgeons. Therefore conventional appendectomy using a right lower lateral McBurney incision should continue to be the gold standard. Surgeons who have extensive experience in the field of laparoscopic surgery can achieve better results with minimally invasive appendectomy than with open surgery. This also holds true for specific situations such as complicated appendicitis and for morbidly obese patients. However, the operating costs incurred for laparoscopic appendectomy are higher because it has been shown that removal of the appendix with a linear stapler is the most reliable method.

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“…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]. Additionally, the advent of wound complications after a laparoscopic intervention is much less frequent than after a conventional McBurney's incision with a rate estimated between 0 and 8% [1,5].…”

Section: Acute Appendicitis: Laparoscopic Approachmentioning

confidence: 99%

“…It appears to be significantly lower as compared to OA [1,5]. Additionally, the advent of wound complications after a laparoscopic intervention is much less frequent than after a conventional McBurney's incision with a rate estimated between 0 and 8% [1,5]. …”

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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Laparoscopic Versus Open Appendectomy

Abstract: Laparoscopic appendectomy has significant advantages over open appendectomy with respect to length of hospital stay, rate of routine discharge, and postoperative in-hospital morbidity.

Cited by 402 publications

References 43 publications

Kindliche Appendizitis

Kindliche Appendizitis

Laparoskopische Appendektomie

Appendicitis/Diverticulitis: Minimally Invasive Surgery

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