Clinical Outcomes and Costs of Laparoscopic Versus Open Appendectomy for Appendicitis

Abstract

Abstract:Purpose: The aim of this study was to compare clinical outcomes between open appendectomy (OA) and laparoscopic appendectomy (LA) for both uncomplicated appendicitis (UA) and complicated appendicitis (CA) and to help to choose the appropriate procedure for its management. Methods: The medical records of patients who underwent OA (OA group) or LA (LA group) for UA or CA between January 1, 2010 and December 31, 2011, were retrospectively reviewed. Results: For UA, time to a soft diet (1.5±0.7 in OA versus 1.4±0.7 days in LA, p=0.0010) and the length of hospital stay (3.9±1.5 in OA versus 3.3±1.4 days in LA, p<0.0001) were significantly shorter in the LA group. The length of hospital stay for CA was significantly shorter in the LA group than in the OA group (7.5±3.8 versus 4.9±2.8 days, p=0.0012). Complication rates were not significantly different between the LA and OA groups for both UA and CA. Conclusions: We conclude that for CA, clinical outcomes were better in the LA than in the OA group. For UA, there were no significant advantages of LA considering expensive hospital costs. The results of this study suggest that LA is the procedure of choice for patients with complicated appendicitis.

Feasibility of the Short Hospital Stays after Laparoscopic Appendectomy for Uncomplicated Appendicitis

“…Furthermore, hospital stay after laparoscopic appendectomy varies by country, surgeon's preference, and culture. In Korea, postoperative hospital stays after appendectomy for uncomplicated appendicitis range from 3.6 to 6.06 days 6 , 7 , 8 , 9 and from 2.2 to 3 days in other countries. 11 , 12 These longer hospital stays in Korea probably reflect a generous national public medical insurance system.…”

“…Recently, many efforts have been made to reduce hospital costs, and the topic of shortening hospital stay after appendectomy has attracted some interest, especially in the context of one-day surgery, 1 , 2 , 3 , 4 because hospital stays after appendectomy usually exceed 3 days. 5 , 6 , 7 , 8 , 9 The reports issued on this topic have cited hospital stays of from 2.2 to 6 days after uncomplicated appendectomy. 6 , 7 , 8 , 9 , 10 , 11 …”

“… 5 , 6 , 7 , 8 , 9 The reports issued on this topic have cited hospital stays of from 2.2 to 6 days after uncomplicated appendectomy. 6 , 7 , 8 , 9 , 10 , 11 …”