Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis

Abstract

No difference in the rate of postoperative intra-abdominal abscesses exists between laparoscopic and open appendectomy for perforated appendicitis. Wound infections and ileus complicate the postoperative course of patients after laparoscopic appendectomy less frequently than after open appendectomy. The conversion of laparoscopic to open appendectomy for perforated appendicitis is associated with increased postoperative morbidity.

Puntuación diagnóstica para apendicitis: estudio prospectivo de su aplicación por profesionales de salud no-médicos

“…A pesar del abordaje tecnológico actual para el diagnóstico de una patología tan común como la AA [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] , su diagnóstico temprano y acertado es todavía un problema y un desafío 3,7,31 . Las tasas de perforación, apéndices normales y laparotomías negativas varían entre 15% a 40% [4][5][6][7]31,34 .…”

“…precoz de AA y reducir las tasas de diagnósticos tardíos y falsos, se introdujeron técnicas radiológi-cas, estudios de laboratorio y laparoscopia [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] . A pesar de este abordaje tecnológico todavía se operan apéndices normales y perforados 3,15 .…”

Laparoscopic Appendectomy

“…On the contrary, laparoscopic appendectomy in complicated appendicitis is reported to be safe (Ball et al, 2004;Kapischke et al, 2005;Pedersen et al, 2001;Stolzing et al, 2000;Wullstein et al, 2001) and reduce complication rate (Kapischke et al, 2005;Wullstein et al, 2001). Septic wound complications are reported to be less (Piskun et al, 2001;Stolzing et al, 2000). Intraabdominal abscesses are reported to be equally frequent (Asarias et al, 2011;Khalili et al, 1999;Wullstein et al, 2001) in the open and the laparoscopic approach.…”

Study on the Feasibility and the Safety of Hem-o-lok Clipping for Complicated Acute Appendicitis during Laparoscopic Appendectomy

“…3 However, the risk of intra-abdominal abscess development after laparoscopic appendectomy is still a matter of debate, as comparative studies on laparoscopic and open appendectomy have produced variable results, that is, from no difference to an increase after laparoscopic appendectomy. 4,5 Beldi et al 6 described a significantly higher rate for intra-abdominal surgical site infections in their ENDOLOOP group in a non-concurrent cohort study. The technical focus in laparoscopic appendectomy is largely on the treatment of appendiceal stump closure.…”

“…However, complicated appendicitis can result in significant morbidity. [4][5][6] Complicated appendicitis with a perforation, an abscess, or generalized peritonitis is still associated with increased postoperative morbidity, whereas uncomplicated appendicitis has a low complication rate. 10 Control of the appendiceal stump is crucial during laparoscopic appendectomy, and is commonly achieved using ENDOLOOPs or endovascular gastrointestinal anastomosis (GIA) stapling device.…”