Laparoscopic versus open appendicectomy: A prospective assessment

Abstract

A prospective study of 200 consecutive patients with suspected acute appendicitis was performed to compare open and laparoscopic appendicectomy. Formal randomization was precluded by instrument availability. Some 100 patients underwent laparoscopic appendicectomy (conversion to laparotomy was carried out in five) and 100 had conventional surgery. The groups were similar in sex ratio, age, degree of appendiceal inflammation and antibiotic treatment. The mean duration of open appendicectomy was 46 min and of the laparoscopic procedure 51 min (P not significant). Postoperative complications in patients who underwent laparoscopic appendicectomy included: intra-abdominal abscess (two patients), wound infection (one), early bowel obstruction (four; all resolved with medical treatment) and umbilical haematoma (two). There were no reoperations in the immediate or late postoperative period. Complications after open operation were: wound infection (seven patients) (P < 0.05), early bowel obstruction (five; three resolved with medical treatment, two required surgery) and haematoma of the surgical wound (one). The mean hospital stay was 4.8 days for laparoscopic appendicectomy and 6.0 days for the open operation (P < 0.05). There were no deaths.

Laparoscopic versus open appendectomy: a prospective comparative study

“…A study from Nepal 12 also showed significant decrease in the length of hospital stay in patients undergoing LA (p<0.001), which is consistent with the findings of other studies. [13][14] In accordance with other studies, 2,12 there was fewer wound infection in LA group 2.5%, with the post operative complication of 8.5%. In a study by Tate et al they highlighted the difference in wound complication rates as a major benefit of laparoscopic appendicectomy.…”

Laparoscopic Appendectomy in Switzerland: A Prospective Audit of 2,179 Cases

“…Most of the published studies revealed a lower wound infection rate after LA which is in fact the sole advantage [3, 4, 7]. In our study, we found a wound infection rate of 3.5%, which is rather low and within the range of the data from other studies [7, 8, 9, 10, 11, 12, 13, 14, 15, 16]. …”

“…Generally, the available data show no clear evidence of patient benefit after LA [8, 9, 10, 11, 12, 13, 14, 15, 16]. Most of the published studies revealed a lower wound infection rate after LA which is in fact the sole advantage [3, 4, 7].…”

A comparative study of laparoscopic appendicectomy versus open appendicectomy

“…24 According to Jalujan Mompean 25 early bowel obstruction was seen in 4 after laparoscopic appendicectomy and 5 cases after open appendicectomy incidence of bowel obstruction did not differ between laparoscopic appendicectomy and open appendicectomy in either group.…”