Choice of Approach for Appendicectomy: A Meta-analysis of Open Versus Laparoscopic Appendicectomy

Bennett, John M.; Boddy, Alex; Rhodes, Michael

doi:10.1097/sle.0b013e318058a117

Cited by 136 publications

(113 citation statements)

References 37 publications

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“…A recent meta-analysis has reported that the likelihood of intra-abdominal abscess was higher in OA as compared to LA (22). In our study, symptomatic intra-abdominal collection developed in 2 patients (6.5%) in the LA group, and they were both treated with percutaneous drainage.…”

Section: Discussionmentioning

confidence: 52%

Should appendectomy be performed laparoscopically? Clinical prospective randomized trial

Mantoğlu¹,

Karıp²,

Mestan³

et al. 2015

UCD

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Objective: Laparoscopic appendectomy (LA) has been described in 1983, and its superiority over open appendectomy (OA) is still being debated. Currently, there is no agreement on the advantages of LA. Postoperative pain is reported to be lower along with a faster return to normal activities in LA. However, some studies do not support these findings. In our study, we aimed to compare the outcomes and cost effectiveness of LA and OA. Material and Methods:Patients were prospectively randomized into LA (31 patients) and OA (32 patients) groups. Demographic data, pre-and postoperative C-reactive protein (CRP) levels, white blood cell (WBC) count, duration of surgery and hospitalization, complications, and pain scores (VAS) were recorded. Cost was calculated for both groups. Return to normal activities was evaluated by phone calls at the first and second week and 1 month after surgery.Results: There was a significant postoperative decrease in WBC count in the LA group (p<0.01). There were no differences between LA and OA groups in terms of postoperative CRP levels (p>0.05). The rates of wound infection and abscess were similar (p>0.05), while post-operative pain and time to return to normal activities were higher in the OA group (p<0.01). There was a positive correlation between BMI and operative time in the LA group (p<0.01), while BMI and operative time did not show a correlation in the OA group (p>0,05). The average cost in the LA and OA groups were 1960.5±339.05 and 687.115±159.5 TL, respectively. Conclusion:LA is an effective method in the treatment of acute appendicitis due to less pain and faster recovery. LA can be the choice of treatment in acute appendicitis, with utilization of re-useable and cheaper vascular sealing devices.

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Section: Discussionmentioning

confidence: 52%

Should appendectomy be performed laparoscopically? Clinical prospective randomized trial

Mantoğlu¹,

Karıp²,

Mestan³

et al. 2015

UCD

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“…It is also gaining popularity because of shorter operative time, less postoperative pain, and lesser incidence of surgical site infection [8][9][10][11][12][13][14]. Its only drawback is slightly higher rate of intra-abdominal abscess [15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

Conventional Laparoscopic Appendicectomy and Laparoscope-Assisted Appendicectomy: a Comparative Study

Baid

Kar

De³

et al. 2013

Indian J Surg

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Laparoscopic procedures for removal of the appendix by the three-port technique as an alternative to conventional appendicectomy have gained wide popularity, but they have been criticized for technical difficulty, more time consumption, and high cost. We have compared conventional three-port laparoscopic appendicectomy (LA) and laparoscope-assisted appendicectomy (LAA). In period from August 2010 to January 2012, 77 patients underwent appendicectomy by a minimally invasive procedure (39 LA and 38 LAA), at Medical College and Hospital, Kolkata. All the 39 cases of LA were completed successfully, but of the 38 cases, LAA could be completed only in 32 cases. Of the six cases where LAA could not be completed, five were converted to LA [three because of excessive body mass index (BMI) and two because of bleeding]. One case had to be converted to open appendicectomy because of excessive bleeding. In LA, the mean duration of surgery was less than that in LAA (18.18 versus 24.39 min). Wound infections were more common in LAA compared to LA (six versus two). Severe postoperative pain was present in eight cases in LAA compared to two in LA. On day 2, 79.487 % patients undergoing LA were discharged compared to 28.947 % in LAA. LA is better as a minimally invasive procedure. LAA can only be done in patients with lower BMI, is more time consuming, has more complications, more incidence of postoperative pain, wound infections, and longer hospital stay.

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“…У метааналізі, що об'єднав рандомізо-вані клінічні дослідження 1995-2006 рр., проведе-ному J. Bennett та співавт. (2007), було наведено дані, що ІАА при ЛАЕ розвивається в 2,26 раза частіше [15]. Водночас останнім часом у літерату-рі відмічено тенденцію до значного зниження цьо-го показника, навіть до повної відсутності різниці при ЛАЕ і ВАЕ.…”

Section: з досвіду роботиunclassified

Поєднання Лапароскопічних Та Електрозварювальних Технологій У Лікуванні Хворих З Гострим Апендицитом Як Фактор Профілактики Інтраабдомінальних Ускладнень

Savoliuk¹,

Balatskyi²

2016

ШХ

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У роботі проаналізовано результати операційного лікування 96 хворих із гострим апендицитом. Серед пацієнтів пере-важали жінки -54 (56,3 %). Всім хворим виконували лапароскопічну апендектомію як під загальною анестезією, так і регіонарним знеболюванням. Хворим основної групи обробку брижі та формування кукси червоподібного відростка виконували методом зварювання живих тканин. У контрольній групі обробку брижі здійснювали традиційною коагуляцією та кліпуванням, а формування кукси проводили лігатурним методом, з обробкою її монополярною коагуляцією. При мікробіологічному дослідженні із кукси червоподібного відростка в основній групі пацієнтів ро-сту мікроорганізмів не виявлено у 100 %, в контрольній групі після обробки кукси монополярною коагуляцією у 9 (27,3 %) виявили помірний бактеріологічний ріст (p>0,05). Інтраабдомінальних ускладнень в основній групі не вияв-лено, в контрольній діагностовано інфільтрат у правій здухвинній ділянці без клінічних проявів у післяопераційному періоді у 4 (12,1 %) пацієнтів (p>0,05). Медикаментозне лікування пацієнти основної групи отримували 1-2 дні (p<0,05), контрольної 3-4 дні. Середній ліжко-день в основній групі склав (1,5±0,5) доби (p<0,05), в контрольній -(3,0±0,5) доби. Поєднання лапароскопічних та електрозварювальних технологій у лікуванні хворих з гострим апендицитом характеризується зменшенням ризику виникнення післяопераційних інтраабдомінальних ускладнень або повною їх відсутністю, меншим больовим синдромом у післяопераційному періоді, коротким періодом стаціонарного лікування та швидкою реабілітацією.In the study there were analyzed cases of 96 patients with acute appendicitis. Among the patients there were predominantly women, 54 cases (56.3 %). All the patients underwent laparoscopic appendectomy by using general and local anesthesia. The mesentery treatment and vermiform appendix stump formation were carried out by using electric welding of biological tissues in the patients of the main group. In the patients of the control group mesentery treatment was performed with traditional coagulation and clipping while the vermiform appendix stump was formed with monopolar coagulation by using ligature technique. The microbiological studying of the vermiform appendix stump didn't show microorganisms growth in the main group of patients (100 %). However, after monopolar coagulation there was detected median bacterial growth in the control group (p>0.05). There were no intraabdominal complications reported in the main group, whereas in 4 cases (12.1 %) of the control group there was diagnosed non clinically manifested infiltration in the right iliac region during postoperative period (p>0.05). The patient of the main group received drug treatment during 1-2 days (p<0.05), the patient of the control group -3-4 days. The average patient day in hospital was (1.5±0.5) days. The combination of laparoscopic and electric welding techniques in treatment of patients with acute appendicitis is characterized by a decreased risk of postoperative intraabdominal complications or their comp...

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Choice of Approach for Appendicectomy: A Meta-analysis of Open Versus Laparoscopic Appendicectomy

Cited by 136 publications

References 37 publications

Should appendectomy be performed laparoscopically? Clinical prospective randomized trial

Should appendectomy be performed laparoscopically? Clinical prospective randomized trial

Conventional Laparoscopic Appendicectomy and Laparoscope-Assisted Appendicectomy: a Comparative Study

Поєднання Лапароскопічних Та Електрозварювальних Технологій У Лікуванні Хворих З Гострим Апендицитом Як Фактор Профілактики Інтраабдомінальних Ускладнень

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