Transumbilical Laparoscopic Assisted Appendectomy Compared with Transumbilical Laparoscopic Appendectomy in Acute Appendicitis- Analysis of 1000 Cases

Abstract

Background: Acute appendicitis (AA) is the most common cause of acute abdominal surgery. The available scientific evidence does not show consensus of opinion about the best access route for the treatment of AA. Aim: To compare the techniques Laparoscopic Appendectomy (LA) and Transumbilical Laparoscpoic Assisted Appendectomy (TULAA). Methods: This is a retrospective study comparing two series with 1000 patients. Variables were: operative time, hospital stay, postoperative complications, postoperative pain, earlier return to daily activities, conversion in relation to the type of operation and motive of the conversion. Results: The averaged surgical time was 75.5 minutes in LA and 51.7 minutes in TULAA. The incidence of postoperative pain showed no statistically significant difference. General complications had incidence of 9.6% in LA and 7.6% in TULAA. Regarding to wound infection the incidence was 2.7% and 2.4% to LA group and TULAA group respectively. The earlier return to daily activities and short hospital stay were observed in both groups. When conversion was necessary in TULAA group, the techniques were laparotomic appendectomy (59.4%), LA (17.4%) and TULAA with a second incision (23.2%). The patients submitted to LA who needed conversion were treated by laparotomic technique. Conclusion: The effectiveness and safety of trans-umbilical laparoscopic appendectomy can make this technique the preferred choice in the initial management of patients with acute appendicitis.