Results of laparoscopic vs. conventional appendectomy in complicated appendicitis

Abstract

In comparison with open appendectomy, laparoscopic appendectomy (by itself and in an intention-to-treat view) leads to a significant reduction of early postoperative complications in complicated appendicitis and therefore should be considered as the procedure of choice.

Puntuación diagnóstica para apendicitis: estudio prospectivo de su aplicación por profesionales de salud no-médicos

“…A pesar del abordaje tecnológico actual para el diagnóstico de una patología tan común como la AA [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] , su diagnóstico temprano y acertado es todavía un problema y un desafío 3,7,31 . Las tasas de perforación, apéndices normales y laparotomías negativas varían entre 15% a 40% [4][5][6][7]31,34 .…”

“…precoz de AA y reducir las tasas de diagnósticos tardíos y falsos, se introdujeron técnicas radiológi-cas, estudios de laboratorio y laparoscopia [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] . A pesar de este abordaje tecnológico todavía se operan apéndices normales y perforados 3,15 .…”

Laparoscopic Appendectomy

“…Septic wound complications are reported to be less (Piskun et al, 2001;Stolzing et al, 2000). Intraabdominal abscesses are reported to be equally frequent (Asarias et al, 2011;Khalili et al, 1999;Wullstein et al, 2001) in the open and the laparoscopic approach. Also laparoscopic appendectomy in complicated appendicitis is supposed to lead to a shorter length of stay (Ball et al, 2004;Johnson et al, 1998;Kapischke et al, 2005;Towfigh et al, 2006) and reduced hospital costs (Johnson et al, 1998).…”

“…A learning curve was apparent for the first 100 appendectomies, where we had a conversion rate of 9%, but these patients were not included in the trial. Conversion rate is reported to be increased in complicated appendicitis (Wullstein et al, 2001). The most common reason for conversion is reported to be dense adhesions due to inflammation, followed by localized perforation and diffuse peritonitis (Agresta et al, 2003;Liu et al, 2002).…”

“…On the other hand many authors do not regard complicated appendicitis to be a contraindication for laparoscopic appendectomy. On the contrary, laparoscopic appendectomy in complicated appendicitis is reported to be safe (Ball et al, 2004;Kapischke et al, 2005;Pedersen et al, 2001;Stolzing et al, 2000;Wullstein et al, 2001) and reduce complication rate (Kapischke et al, 2005;Wullstein et al, 2001). Septic wound complications are reported to be less (Piskun et al, 2001;Stolzing et al, 2000).…”