Background. Laparoscopic appendectomy is established method in the treatment of complicated appendicitis. Certain advantages of the technique do not fulfill the expectations for its superiority over the open appendectomy as when it is used for uncomplicated appendicitis. This is generally caused because of the high variety of postoperative complications reported in different series for complicated appendicitis. Material and methods. This prospective interventional clinical study analyzes 61 patients operated with laparoscopic and open appendectomy due to complicated appendicitis, with an end point of comparing the intra and postoperative complications in both groups. Results. Conversion in open appendectomy was forced in one patient (1.63%). The operative time was significantly shorter in the laparoscopic group (p = 0.048). Wound infection was significantly predominant in the open group (p = 0.045). Postoperative intraabdominal abscess occurred in one patient in the laparoscopic group (p = 0.52). The overall morbidity was 26.2% (7 patients in the laparoscopic, and 9 in the open group; p = 0.59). Length of stay was significantly shorter in the laparoscopic group (p = 0.00001). Conclusion. Certain significant advantages of the laparoscopic appendectomy as low incidence of wound infection, short hospitalization, less postoperative pain and faster socialization makes the laparoscopy up to date method in the treatment of complicated appendicitis.

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As one of the most frequent malignancies in the world's population, colorectal cancer is also associated with its complications (perforation, obstruction and bleeding). Their incidence is common (2.6-50%), but synchronous occurrence of two of them in a patient is a rare condition and it is reported in small series or as a case report in the literature. We present a case of the descending colon cancer in a female patient that presented with perforation on tumor site with consecutive retroperitoneal and lumbar abscess and simultaneous presentation of large bowel obstruction. The patient was admitted and operated the same day, the abscess was opened and drained and bowel resection was performed with colostomy creation. The postoperative recovery was uneventful and the patient was discharged on postoperative day 10. Due to the high morbidity/mortality in cases of colon cancer emergencies, Hartman's procedure is often a reasonable option. Timely diagnosis of the colon cancer can reduce the complication rate of the disease worldwide.

INTRODUCTION: After the introduction of laparoscopic appendectomy (LA) in 1981, it is used as one of the operative methods in the treatment of acute appendicitis ever since. Some of the surgeons almost completely replaced open appendectomy (OA) by its laparoscopic alternative, while others still have doubts about its universality. Early postoperative outcome has acceptable results when these two methods are compared, and that is the aim of this study. PATIENTS AND METHODS: This retrospective study includes 798 patients operated for the diagnosis of acute appendicitis in period 2012-2016. Both OA and LA were made by four surgeons in 650 and 148 patients, respectively. RESULTS: Intrahospital mortality in OA group was 0.3% (2 patients) and 0.6% in the LA group (1 patient). Early postoperative outcome was measured through the length of stay (5.1 for OA and 3.1 for LA), superficial surgical site infections-4.7% in OA versus 2.7% in LA. Postoperative intraabdominal abscess occurred in 2% (OA) and 4.05% (OA). The conversion rate was 4.7%. CONCLUSION: Open appendectomy and LA are both used as two surgical alternatives in the treatment of acute appendicitis with comparable early postoperative outcomes. Although LA is almost 100 years younger as an operative method, OA is still widely used. The choice of the procedure should be probably based on surgeon or patient preference.