Laparoscopic versus conventional appendectomy - a meta-analysis of randomized controlled trials

Li, Xiaohang; Zhang, Jialin; Sang, Li-Xuan; Zhang, Wenliang; Chu, Zhiqiang; Li, Xin; Liu, Yongfeng

doi:10.1186/1471-230x-10-129

Cited by 320 publications

(254 citation statements)

References 61 publications

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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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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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“…The length of hospital stay and RTNA are important indicators of patient recovery; many studies have shown that the length of hospital stay and RTNA are shorter in patients who underwent LA than in those who underwent OA (17)(18)(19)(20). In a study on LA conducted by Shaikh et al (17), the hospital stay time and RTNA were found to be 1.7 and 12.6 days, respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of open appendectomy and laparoscopic appendectomy with laparoscopic intracorporeal knotting and glove endobag techniques: A prospective observational study

Aziret¹,

Çetinkünar²,

Erdem³

et al. 2017

Turk J Surg

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INTRODUCTIONAcute appendicitis is one of the most common causes of acute abdomen in all ages. It occurs more frequently in men than in women (male/female: 1.3/1); the mean and median ages related to this pathology are 31.3 and 22 years, respectively (1-3). Open appendectomy (OA), which was first described by McBurney (4) in 1894, is the most frequently performed emergency abdominal operation in the world. However, the use of the laparoscopic appendectomy (LA) procedure has rapidly increased since it was first described by Semm in 1984 (5). Although LA is commonly performed for acute appendicitis, it is not always the best treatment choice. Many studies comparing LA and OA with respect to treatment and follow-up have been conducted. These studies have reported less postoperative surgical-site infection, decreased need for analgesics, much greater visualization, rapid healing, shorter hospital stay times, and earlier return to normal activity (RTNA) rates associated with LA (6-10). However, because of the high costs related to endostaplers, endoclips, and knottings, LA is not the most efficient operation technique (11, 12).Our aim in this study is to prospectively compare OA and LA performed with laparoscopic intracorporeal knotting and glove endobag; we also wish to demonstrate that the latter is a facile and effective alternative LA procedure. MATERIAL AND METHODS Methodology and EthicsThis study was conducted in the Surgery Department at Kars Harakani State Hospital during the period from May 2014 to April 2015. A total of 72 patients who were treated for acute appendicitis were eligible for the study. These 72 patients were divided into two groups: the LA group (group 1) (n=36) and the OA group (group 2) (n=36). All the patients were evaluated in terms of age; gender; perioperative symptoms Objective: Despite the recent increase in the use of laparoscopic appendectomy procedures to treat acute appendicitis, laparoscopic appendectomy is not necessarily the best treatment modality. The aim of this study is to examine the value of laparoscopic intracorporeal knotting and glove endobag in terms of various parameters and in terms of reducing the costs related to laparoscopic appendectomy procedures.Material and Methods: Seventy-two acute appendicitis patients who underwent laparoscopic appendectomy and open appendectomy surgery were enrolled in the study and were evaluated prospectively. The patients were divided into two groups: group 1 was treated with laparoscopic appendectomy using laparoscopic intracorpreal knotting and glove endobag (n=36) and group 2 was treated with open appendectomy (n=36). The two groups were statistically compared in terms of preoperative symptoms and signs, laboratory and imaging findings, operation time and technique, pain score, gas and stool outputs, duration of hospital stay, return to normal activity, and complications. Results:No statistically significant differences were found between the groups in relation to gender, age, body mass index, or pre-operation findings, which include...

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“…A worldwide spread of training in laparoscopic techniques lead to a significant reduction in difference of operative time compared to open procedures after 2000, as evidenced by one of the meta-analyses. 12 In our study, the difference between the duration of postoperative ileus for two different approaches was statistically significant. Recovery of the bowel function was faster in the LA group (30.64±14.24) vs 11.61±4, p Value 0.00).…”

Section: Discussionmentioning

confidence: 75%

Is the laparoscopic approach superior to open approach for treatment of acute appendicitis? A hospital based experience

2017

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Background: Laparoscopic appendicetomy remains controversial in Indian perspective. The objective was to compare the clinical outcome of open with laparoscopic appendicectomy.Methods: Prospectively collected data from 150 consecutive patients with acute appendicitis was studied. Patients undergoing surgery for acute appendicitis were alternately assigned into one of the two groups (Group-A patients underwent open appendicectomy and in Group B laparoscopic appendicectomy). The two groups were compared with respect to operative time, length of hospital stay, postoperative pain & wound complications.Results: The mean operative time in the open group was 84.40 minutes; for laparoscopic group, 95.20 minutes (p-0.001). Duration of paralytic ileus, tolerance to oral feeds, resumption of daily routine activity and ambulation of patients were started earlier in laparoscopic group than open group. Group A (OA) patients had pain at the mean of 2.66 days as compared group B (LA), in which patients had pain at the mean of 1.66 days. Study also showed that the hospital stay for laparoscopic group was almost half of that for open group. Laparoscopic appendicectomy was safe as compared to open surgery in context to post-operative complications.Conclusions: Provided surgical experience and equipment are available, Laparoscopic appendicectomy is as safe and efficient than open appendicectomy.

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Laparoscopic versus conventional appendectomy - a meta-analysis of randomized controlled trials

Cited by 320 publications

References 61 publications

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

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

Comparison of open appendectomy and laparoscopic appendectomy with laparoscopic intracorporeal knotting and glove endobag techniques: A prospective observational study

Is the laparoscopic approach superior to open approach for treatment of acute appendicitis? A hospital based experience

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