Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial

Talha, Ahmed; El-Haddad, Hany M.; Ghazal, Abd-Elhamid; Shehata, Gihan M.

doi:10.1007/s00464-019-06847-2

Cited by 34 publications

(36 citation statements)

References 37 publications

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“… 17 Laparoscopic appendectomy has the advantage of less postoperative pain and short hospital stay. 18 In addition, development of multimodal pain managements, such as rectus sheath block and preoperative pain education, can contribute to the reduction in LOH. 19 20 In a recently conducted randomized clinical trial, it was demonstrated that enhanced recovery after surgery program can be applied in the field of laparoscopic appendectomy.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Appendectomy Incidence and Computed Tomography Scans Based on Korean Nationwide Data, 2003–2017

et al. 2022

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Background Advances in medicine and changes in the medical environment can affect the diagnosis and treatment of diseases. The main purpose of the present study was to investigate whether the difference in accessibility to diagnosis and treatment facilities influenced the occurrence of appendectomy in Korea. Methods We collected data on 183,531 appendectomy patients between 2003 and 2017 using the National Health Insurance Services claims. Retrospective analysis of relationship between the age-standardized rate (ASR) of appendectomy and clinical variables affecting medical accessibility was performed. Pearson’s correlation analyses were used. Results The incidence of appendectomy decreased from 30,164 cases in 2003 to 7,355 cases in 2017. The rate of computerized tomography (CT) scans for diagnosis of appendicitis increased from 4.73% in 2003 to 86.96% in 2017. The ASR of appendectomy in uncomplicated and complicated appendicitis decreased from 48.71 in 2005 to 13.40 in 2010 and 8.37 in 2005 to 2.96 in 2009, respectively. The ASR of appendectomy was higher in the high-income group. The proportion and ASR of appendectomy in older age group increased steadily with years. The total admission days continued to decrease from 6.02 days in 2003 to 4.96 days in 2017. Conclusion The incidence of appendectomy was seemingly associated with the rate of CT scan. In particular, the incidence of appendectomy in uncomplicated appendicitis was markedly reduced. Through enhanced accessibility to CT scans, accurate diagnosis and treatment of appendicitis can be facilitated.

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Section: Discussionmentioning

confidence: 99%

Relationship Between Appendectomy Incidence and Computed Tomography Scans Based on Korean Nationwide Data, 2003–2017

et al. 2022

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“…Intraabdominal abscess occurrence is a serious postoperative complication that requires adequate treatment (sometimes a surgical one). Different series show heterogeneous data about its rate when compared between LA and OA [12,16,[25][26][27][28]. Certain attempts are made in order to reduce its incidence such as reduction of the pneumoperitoneum pressure (low intraabdominal pressure) for eventual positive impact on bacterial translocation in the bloodstream [29,30].…”

Section: Discussionmentioning

confidence: 99%

“…Certain attempts are made in order to reduce its incidence such as reduction of the pneumoperitoneum pressure (low intraabdominal pressure) for eventual positive impact on bacterial translocation in the bloodstream [29,30]. Further, pus collection suction with complete adhesiolysis and generous intraabdominal lavage with multiple drains are proposed [28]. Other authors suggest that intraabdominal lavage rises the incidence of IAA so they recommend only pus collection suction [12,31,32].…”

Section: Discussionmentioning

confidence: 99%

Complications after Laparoscopic Appendectomy for Complicated Appendicitis

Nikolovski¹,

Tahir²,

Mladenovikj³

2020

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Background. Laparoscopic appendectomy is established method in the treatment of complicated appendicitis. Certain advantages of the technique do not fulfill the expectations for its superiority over the open appendectomy as when it is used for uncomplicated appendicitis. This is generally caused because of the high variety of postoperative complications reported in different series for complicated appendicitis. Material and methods. This prospective interventional clinical study analyzes 61 patients operated with laparoscopic and open appendectomy due to complicated appendicitis, with an end point of comparing the intra and postoperative complications in both groups. Results. Conversion in open appendectomy was forced in one patient (1.63%). The operative time was significantly shorter in the laparoscopic group (p = 0.048). Wound infection was significantly predominant in the open group (p = 0.045). Postoperative intraabdominal abscess occurred in one patient in the laparoscopic group (p = 0.52). The overall morbidity was 26.2% (7 patients in the laparoscopic, and 9 in the open group; p = 0.59). Length of stay was significantly shorter in the laparoscopic group (p = 0.00001). Conclusion. Certain significant advantages of the laparoscopic appendectomy as low incidence of wound infection, short hospitalization, less postoperative pain and faster socialization makes the laparoscopy up to date method in the treatment of complicated appendicitis.

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“…There are also publications showing that there is no significant difference in operative time between the two techniques [23]. Regardless of the stump closure technique, the mean operative times for different studies in the literature for laparoscopic treatment of complicated appendicitis were reported to be 73.1 ±25.6 [3], 69.4 ±26.4 [10], 116.7 ±45.7 [20], 120.6 ±17.7 [34] and 84.6 ±34.5 [31] min. These differences in operation times can be explained by the different stages of diseases and the variability of the technique used.…”

Section: Comparing the Laparoscopic And Open Technique Inmentioning

confidence: 99%

Partial cecum resection using endostapler in acute complicated appendicitis with appendiceal base necrosis.

Yılmaz¹,

Dönmez²,

Ferahman³

et al. 2021

Videosurgery and Other Miniinvasive Techniques

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Introduction:The method of stump closure is controversial in complicated patients, especially with appendix base necrosis or perforation. Aim: To evaluate the efficacy and safety of partial cecum resection technique with an endostapler in patients with appendix base necrosis or perforation. Material and methods: Thirty-six patients who underwent laparoscopic partial cecum resection due to appendix base necrosis or perforation between 2015 and 2020 were retrospectively analyzed. In acute complicated appendicitis with appendiceal base necrosis or perforation, it was performed by laparoscopic partial cecum resection using an endostapler within a safe surgical margin. Demographic characteristics, duration of operation, days of hospital stay, and intra-and post-operative complications were evaluated. Results: The mean age of the patients is 42.72 ±16.69, female/male ratio was 19/17 (52.8%/47.2%). No intraoperative complications developed. Mean operative time and hospital stay were 104.75 ±34.96, 4.58 ±2.82 days, respectively. Post-operative complications developed in 5 (13.7%) patients. One of them was wound infection (2.7%), 2 of them were ileus (5.5%) and 2 patients had an intraabdominal abscess (5.5%). Stapler line leak was not observed in any of the patients. Conclusions: The use of an endostapler in laparoscopic appendectomy is a safe and effective technique in cases where appendix base necrosis, appendix perforation or severe inflammation affects the base of the cecum.

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Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial

Cited by 34 publications

References 37 publications

Relationship Between Appendectomy Incidence and Computed Tomography Scans Based on Korean Nationwide Data, 2003–2017

Relationship Between Appendectomy Incidence and Computed Tomography Scans Based on Korean Nationwide Data, 2003–2017

Complications after Laparoscopic Appendectomy for Complicated Appendicitis

Partial cecum resection using endostapler in acute complicated appendicitis with appendiceal base necrosis.

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