Laparoscopic versus traditional appendectomy for suspected appendicitis

Schirmer, Bruce D.; Schmieg, Robert E.; Dix, Janet; Edge, Stephen B.; Hanks, John B.

doi:10.1016/s0002-9610(05)80785-8

Cited by 75 publications

(36 citation statements)

References 14 publications

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“…Although OA is considered as a safe procedure, a larger incision is occasionally required in obese patients and complicated appendicitis, which might be cosmetically unacceptable and associated with prolonged recovery [1,24]. LA was successfully completed effectively in our study in 88.3% without any major operative complication similar to previous reports [16][17][18][25][26][27][28]. Most of the conversions were during the first stages of the study, and as experience developed, the conversion rate has reduced.…”

Section: Discussionsupporting

confidence: 83%

The Introduction of Laparoscopic Appendectomy in a Teaching Hospital

et al. 1999

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Objectives: A retrospective study of laparoscopic appendectomy (LA) versus open appendectomy (OA) was performed on patients with suspected acute appendicitis. Patients were selected for OA or LA according to the clinical evaluation, and preference of the surgeon. Methods: Over a 2-year period 180 patients were included, of whom 94 patients underwent OA, and 86 patients underwent LA. Results: LA was successfully completed in 76 patients (88.3%). The mean hospital stay in OA was 3.2 days versus 2.7 days in LA. The mean operative time was shorter in OA than in LA (51.6 versus 59.8 min). There was no significant difference in convalescence between both the groups, however, there was a tendency towards less narcotic requirement among the LA group. Postoperative complications in patients who underwent OA included: chest infection (3 patients), wound infection (4 patients), thrombophlebitis (1 patient). Complications after LA included: pelvic collection (1 patient), chest infection (1 patient), ileus (1 patient). There was no wound infection in the LA group. There was no death in either groups. Conclusion: LA is a safe procedure comparable to OA, however, it requires skills in laparoscopy and prospective randomized trials are needed to confirm its advantages over conventional appendectomy.

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Section: Discussionsupporting

confidence: 83%

The Introduction of Laparoscopic Appendectomy in a Teaching Hospital

et al. 1999

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“…In a nonrandomized trial of 122 patients Schirmer et al found no significant difference in hospital stay. 16 Some recent retrospective cohort studies [17][18][19] shows a significant shorter hospital stay after LA while other shows no significant differences in hospital stay .20, 21 CONCLUSION: This study identified the value of the laparoscopic technique for appendectomy in a non-specialist center. This benefits the patients with its low morbidity, shorter hospital stay, minimal operating time and quicker recovery.…”

Section: Discussionmentioning

confidence: 79%

Laparoscopic Versus Open Appendectomy: Retrospective Comparison in Rural Urban Settings

Nigam¹,

Devpura²,

Nigam³

et al. 2014

jemds

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OBJECTIVE:This retrospective comparative study was undertaken from data of various peripheral centers of Kanpur and around, to assess the impact of Laparoscopic Appendectomy on the patients care where prior to it, conventional open appendectomy (OA) was in vogue. PATIENTS AND METHODS: This retrospective study was done on the patients who were operated by different surgeons in different peripheral hospitals for appendectomy during period of 36 months (from Dec 2010 to Nov 2013).Total data of 360 patients collected out of which the number in each group of patients who underwent laparoscopic appendectomy and patients who had open procedure kept same i.e. 180. Each patient's data was selected in a non-randomized fashion. Both groups were studied for length of hospital stay, operating time, complications and conversion rate and cost involved (consumables only). RESULTS: Analysis of both groups within same interim period showed same age/sex distribution and diagnosis was made mainly on clinical grounds supported by hematological and ultra-sonology tests. Within the laparoscopic group, average length of stay was 3.14 (2-4) days, compared with 4.19 (2-7) days of open appendectomy. Operating time for laparoscopic group was 1.02 (1-1.5) hours with only six conversion into Lanz incisions. In the open group the operating time was 51.5 min (30-90min) and there were 40 laparotomies due to uncertain diagnosis, in three cases due to extensive adhesions appendectomy could not be performed. 28 of these cases also required adjunctive imaging for diagnostic purposes. CONCLUSIONS: This study identified the value of the laparoscopic technique for appendectomy in a non-specialist center. This benefits the patients with low morbidity, shorter hospital stay, minimal operating time and quicker recovery. Cost factors and expertize available however refrain these peripheral hospitals to adopt laparoscopic appendectomy as routine procedures. But these results show that practice of LA also inspired the practitioners of low experience to take on this procedure with confidence and maintain their laparoscopic skills which potentially could be utilized for other related laparoscopic operations.

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“…Since then there have been a large number of reports on the procedure [111][112][113][114][115][116][117][118][119][120][121][122], Intuitively, the laparo scopic approach does not have much to gain over open appendicectomy as it does over open cholecystectomy, since the small mus cle-splitting right iliac fossa incision is already minimally invasive and produces little mor bidity. Also, the patient has to recover from the effects of the appendicitis rather than just the surgical wound.…”

Section: Laparoscopic Appendicectomymentioning

confidence: 99%

“…However, the other two trials [118,119] found a significant reduc tion in postoperative pain, analgesia require ment, hospital stay, time to return to normal activities, and wound complications after the laparoscopic method. Non-randomized com parative studies have also found significant advantages in favour of the laparoscopic method [113][114][115][116][117]122]. However, the gains over open appendicectomy in terms of pain Laparoscopic Interventions in the Gut: Yesterday, Today, and Tomorrow and recovery time are modest.…”

Section: Laparoscopic Appendicectomymentioning

confidence: 99%

“…One possible long-term advantage might be a reduction in adhesion formation and, therefore, a reduc tion in the incidence of adhesive obstruction [123], Disadvantages of the laparoscopic method are an increase in operation time and the need for a more senior surgeon to perform the operation. Moreover, the modest saving from reduction in hospital stay does not outway the increased costs of longer theatre time and expensive disposable equipment [111,113,116,117], Hence, laparoscopic appendi cectomy, despite being just as feasible as lapa roscopic cholecystectomy, has not received the wide acceptance that the latter procedure has had.…”

Section: Laparoscopic Appendicectomymentioning

confidence: 99%

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Laparoscopic Interventions in the Gut: Yesterday, Today, and Tomorrow

McMahon

O’Dwyer²,

Baxter³

1996

Dig Dis

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The development of laparoscopic interventional surgery has brought about a revolution in general surgery over the past 5 years. Laparoscopic cholecystectomy has now become the treatment of choice for symptomatic cholelithiasis because of a reduction in access trauma, resulting in less postoperative pain and a faster recovery. Laparoscopic fundoplication for gastroeosophageal reflux also looks to be a promising procedure which will probably become generally accepted. Laparoscopic hernia repair, although widely practised, has raised question marks because of doubt about recurrence rates and major complications such as intestinal obstruction. Laparoscopic colectomy has similarly raised concerns about complication rates and tumour recurrence rates. Laparoscopic appendicectomy offers marginal benefits over open appendicectomy. Virtually every other intra-abdominal procedure has been performed laparoscopically, but most require further evaluation.

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Laparoscopic versus traditional appendectomy for suspected appendicitis

Cited by 75 publications

References 14 publications

The Introduction of Laparoscopic Appendectomy in a Teaching Hospital

The Introduction of Laparoscopic Appendectomy in a Teaching Hospital

Laparoscopic Versus Open Appendectomy: Retrospective Comparison in Rural Urban Settings

Laparoscopic Interventions in the Gut: Yesterday, Today, and Tomorrow

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