Short‐ and Long‐Term Results of Open Versus Laparoscopic Appendectomy

Abstract

BackgroundClinical advantages of laparoscopic appendectomy have been shown in numerous trials and reviews. Most of these advantages are small and of limited clinical relevance, while laparoscopic operation costs are reported to be higher. The present study compares short- and long-term results of conventional appendectomy with or without diagnostic laparoscopy (OA), and laparoscopic appendectomy (LA).MethodsAll adult patients who underwent appendectomy in our institution from 1995 to 2005 were included retrospectively. Patient data were retrieved from medical records, questionnaires sent by mail, and records of general practitioners. Primary outcome parameters were long-term complications, readmissions, and reinterventions (>30 days postoperatively). Secondary outcome parameters were short-term complications, readmissions, and reinterventions (≤30 days postoperatively).ResultsA total of 755 patients were included, 545 of whom underwent OA, with the remaining 210 undergoing LA. In the long term there were few complications noted, and there were no significant differences in complications between the two groups. Within 30 days postoperatively, LA was associated with a significantly higher incidence of abdominal abscesses with consequent diagnostic investigations, interventions, and readmissions.ConclusionsAlthough laparoscopic appendectomy is known to deliver clinical advantages, it is associated with a higher incidence of abdominal abscesses. Because the procedure is about to become the standard of care, future research must be directed at solving this issue. The expected lower incidence of incisional hernia and small bowel obstruction after laparoscopic appendectomy was not shown in the present study.

Economics of Appendicitis: Cost Trend Analysis of Laparoscopic Versus Open Appendectomy from 1998 to 2008

“…These patients tend to be older and have complex disease with peritonitis. Swank et al also found that the only significant risk factor for conversion was the presence of a generalized purulent peritonitis [19]. We were unable to examine if these patients had previous operations that increased their risk of conversion.…”

Surgical Wound Infections After Laparoscopic Appendectomy With or Without Using Reusable Retrieval Bag: A Retrospective Study

“…Laparoscopic appendectomy is an increasing procedure in popularity since initially reported by Semm in 1983 (9). Several studies have shown the advantages of laparoscopic surgery in terms of shorter hospital stay, rapid postoperative recovery, and better pain control (10)(11)(12)(13). However, there have been concerns about the risk of infectious complications, particularly the development of intra-abdominal abscess and superficial wound infection (14,15).…”

Immediate appendectomy for appendiceal mass

“…[4] The common complications after immediate appendectomy are wound infection, intestinal fistula, small bowel obstruction, intra-abdominal abscess, and sepsis. [5,6] The aim of this study was to determine whether immediate appendectomy is a safe alternative to conservative management in patients with appendiceal mass.…”