Appendectomy in Women. Is the Laparoscopic Approach Always Better Than the “Open” Approach in Uncomplicated Appendicitis?

Casarotto, Andrea; Zarantonello, F.; Rebonato, M.

doi:10.1097/sle.0000000000000063

Cited by 8 publications

(7 citation statements)

References 15 publications

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“…It is also the most common emergency in abdominal surgery [3]. Since 1889, when McBurney first reported appendectomy as the treatment for acute appendicitis, surgical intervention has been the standard treatment strategy for acute appendicitis [4].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Short-Term Outcome between Laparoscopic and Open Appendectomy in Adults: A Meta-Analysis of Randomized Controlled Trials

Zhang¹,

Gao²,

Wei³

2017

Diagn Pathol Open

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Objective: Despite many randomized controlled trials, it is still not clear whether open appendectomy or laparoscopic appendectomy is the most appropriate surgical approach to acute appendicitis. It is also widely recognized that laparoscopic removal of appendectomy is a well-established procedure with good outcomes. The aim of this study was to evaluate the short-term results of open appendectomy versus laparoscopic appendectomy in adults. Methods:We undertook a meta-analysis of randomized controlled trials comparing open appendectomy and laparoscopic appendectomy in adults. We searched the PubMed, EMBASE, and Cochrane Library databases up to June 20, 2017. Calculations were made of the effect sizes of short-term outcomes: wound infection, intra-abdominal abscess, postoperative complications, peritonitis, postoperative ileus, urinary tract infection, and reoperation, the effect sizes were then pooled by a fixed or random-effects model. Results:Twenty-nine randomized controlled trials with 4311 participants were included. Meta-analysis of the available literature demonstrated that laparoscopic appendectomy in adults was associated with lower incidence of wound infection (OR=0.54, 95% CI: 0.42-0.70, P<0.00001), and fewer postoperative complications (OR=0.77, 95% CI: 0.66-0.90, P= 0.001). Further analysis did not reveal significant differences between the two surgery approaches in intra-abdominal abscess, peritonitis, postoperative ileus, urinary tract infection, and reoperation in adults. Conclusion:Laparoscopic appendectomy reduces wound infections and postoperative complications in the treatment of adult acute appendicitis. Laparoscopic appendectomy is worth recommending as an effective and safe procedure for acute appendicitis in adults.

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Section: Introductionmentioning

confidence: 99%

Comparison of Short-Term Outcome between Laparoscopic and Open Appendectomy in Adults: A Meta-Analysis of Randomized Controlled Trials

Zhang¹,

Gao²,

Wei³

2017

Diagn Pathol Open

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“…Casarotto et al in their study among women patients suggested that the laparoscopic approach should be used in case of unclear abdominal pain. 14 Many studies were done to compare laparoscopic appendectomy and open appendectomy; however, there is still not enough evidence to support that the laparoscopic approach is the standard procedure for complicated appendicitis. The shortcoming of the study is the lack of defined selection criteria for an operative approach for each patient.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic or Open Appendectomy: Which Approach is the Best for Complicated Appendicitis?

Jailani¹,

Jafri²,

Henry³

et al. 2021

World Journal of Laparoscopic Surgery With DVD

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Introduction: Appendicitis is more common in children and young adults. Treatment of appendicitis is either laparoscopic appendicectomy (LA) or open appendicectomy (OA) surgery. Aim and objective: The 30-day postoperative morbidity, surgical site infection, and reoperation rate were compared between open and laparoscopic appendicectomies for complicated appendicitis. Secondary outcome measures were the length of hospital stay, duration of surgery, surgical waiting time, identification of other diseases, and patient satisfaction. Materials and methods: This retrospective study was conducted in two institutions: Hospital Selayang, Selangor, Malaysia, and HUKM, Kuala Lumpur, Malaysia. Data were collected from January 2014 to December 2015 were reviewed. Results: The mean age (±SD) for LA and OA were 32 (±15) and 30 (±14) years, respectively. The males showed predominance in LA and OA with 52 and 72%, respectively (p < 0.001). The majority of LA (73%) and OA (88%) were performed by the trainees (p < 0.001). There was a significant reduction in postoperative morbidity in LA compared to OA in terms of surgical site infection, LA vs OA [n = 8 (2.7) vs 26 (6.3), p = 0.029] and duration of surgery [LA vs OA 84 (±39) vs 68 (± 6) days (p < 0.001)]. However, for LA and OA, there were no significant differences in reoperation, 0.7 and 1.0%, respectively (p = 1.000), and length of stay in LA vs OA 3.55 (±2) vs 3.89 (±3) days, respectively (p = 0.103). Overall, patient satisfaction scores were not found statistically significant as the response rates were only 32% in LA and 30% in OA. Conclusion: LA significantly reduced surgical site infection and offered an advantage in the detection of other pathologies. Hence, a laparoscopic approach should be offered to patients whose clinical diagnoses are challenging.

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“…With a lifetime incidence of 6.7 percent to 8.6 percent 8,9 , appendicitis is the most prevalent cause of acute abdominal pain. It's also the most prevalent abdominal surgery emergency 10 . Endoscopic procedures have been advocated because they are less intrusive, have less problems, and produce better overall results than open appendectomy approaches.…”

Section: Discussionmentioning

confidence: 99%

Compare the Outcomes of Laparoscopic and Open Appendectomy

Ahmad¹,

Muzaffar²,

Khan³

2021

PJMHS

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Aim: The aim of this study is to compare the surgical site infection, hospital stay and time duration of procedure in patients undergoing laparoscopic and open appendectomy. Study Design: Prospective/ Observational Place & Duration: Department of Surgery, Pak Red Crescent Medical and Dental college, Dina Nath, during from Jan 2020 to March 2021. Methods: In this study 240 patients of both genders with ages >10 years presented with acute appendicitis were included. Patients demographic including age, sex and body mass index were recorded after written consent. Patients were equally divided into two groups. Group I consist of 120 patients and received laparoscopic appendectomy and Group II with 120 patients received open appendectomy. Outcomes such as surgical site infection, hospital stay and time duration of procedure were examined and compare the results between both groups. Data was analyzed by SPSS 23.0. P-value <0.05 was set as significant. Results: There were 140 (58.3%) patients (70 Group I, 70 Group II) were male with mean age 25.7+6.54 years while 100 (41.7%) patients (50 Group I, 50 Group II) were females with mean age 26.9+3.12 years. No significant difference regarding BMI between both groups p=>0.05. There was a significant difference in term of surgery time duration between both groups 48.24+9.59 minutes Vs 35.74+6.86 minutes; P=0.001. No significant difference observed in term of hospital stay (p=0.345). 11 (9.2%) patients in Group II in which 5.83% had Superficial SSI and 3.7% had Deep SSI. 9 (7.5%) patients 5% superficial and 2.5% Deep SSI in Group I had developed surgical site infection with no significant difference (p=0.41). Conclusion: We concluded in this study that open appendectomy is better in term of operative time as compared to laparoscopic appendectomy. We found no significant difference regarding surgical site infection and hospital stay. Keywords: Acute appendicitis, Appendectomy, Laparoscopic, Open, Outcomes

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Appendectomy in Women. Is the Laparoscopic Approach Always Better Than the “Open” Approach in Uncomplicated Appendicitis?

Abstract: LAs are not associated with a lower complication rate than the OAs and, above all, LAs are more expensive than OAs. Also we believe that laparoscopic approach should be used only in case of unclear abdominal pain and not for the treatment of clear acute and uncomplicated appendicitis.

Cited by 8 publications

References 15 publications

Comparison of Short-Term Outcome between Laparoscopic and Open Appendectomy in Adults: A Meta-Analysis of Randomized Controlled Trials

Comparison of Short-Term Outcome between Laparoscopic and Open Appendectomy in Adults: A Meta-Analysis of Randomized Controlled Trials

Laparoscopic or Open Appendectomy: Which Approach is the Best for Complicated Appendicitis?

Compare the Outcomes of Laparoscopic and Open Appendectomy

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