Laparoscopic versus open surgery for complicated appendicitis in adults: a randomized controlled trial

Taguchi, Yoshihiko; Komatsu, Shunichiro; Shimizu, Eiji; Norimizu, Shinji; Shingu, Yuji; Hasegawa, Hiroshi

doi:10.1007/s00464-015-4453-x

Cited by 71 publications

(79 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study, the presence of a perforated appendix was associated with a 3- to 4-fold increase in adverse outcomes in multivariable models, including an increased surgical site and organ space (abscess) infection, findings similar to previous studies [21]. It has been debated whether a laparoscopic approach is always appropriate for patients with more advanced disease and peritonitis; however, evidence does exist supporting a laparoscopy even in complicated cases where reduced infection rates and postoperative length of stay can be achieved [22, 23]. …”

Section: Discussionsupporting

confidence: 72%

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study

Collaborative

2018

Surg Endosc

View full text Add to dashboard Cite

BackgroundAppendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide.MethodsThis is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days.Results4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33–4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76–2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42–0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14–0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11–0.44) and SSI (OR 0.21 95% CI 0.09–0.45).ConclusionA laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments.Trial registration: NCT02179112.Electronic supplementary materialThe online version of this article (10.1007/s00464-018-6064-9) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 72%

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study

Collaborative

2018

Surg Endosc

View full text Add to dashboard Cite

show abstract

“…LA is a safe procedure and could be considered as a gold standard for acute appendicitis even in complicated cases (9). In our academic hospital, most of appendectomies are performed by residents in open technique, and only few cases are operated by MIS fellows in laparoscopic technique.…”

Section: Discussionmentioning

confidence: 99%

“…Advantages of LA, include, shorter hospitalization, faster recovery, less postoperative pain, less analgesic necessity, less surgical site infection and better cosmetic results (2,3,5,(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Use of Polymeric Clip (Hem-O-Lock) for Appendiceal Stump Ligation as a Favorable Technique in Laparoscopic Appendectomy

Kermansaravi

Darabi

Eghbali

et al. 2017

J Minim Invasive Surg Sci

View full text Add to dashboard Cite

Background: Laparoscopic appendectomy (LA) has become the standard choice for acute appendicitis. Several techniques to close the appendiceal stump were investigated, and use of polymeric clips, are shown safe and cost effective. Objectives: Evaluation of the efficacy and safety of appendiceal stump closure with polymeric clips in LA. Methods: This is a retrospective cohort study included 35 patients who underwent LA, between April 2013 and August 2016 in Rasoole-Akram university hospital. appendiceal stumps ligation were performed by polymeric clips. One month follow up after surgery was performed for all patients. Demographic information of patinets, surgery, complications, readmission and pathological reports, were collected from medical records and data base. Results: Thirty-five patients were included in this retrospective study. Nineteen patients were male and 16 patients were female

show abstract

“…Open appendicectomy which was introduced by Mc Burney in 1894 has been the gold standard for treating acute appendicitis for more than a century. 3,4 The success of laparoscopic cholecystectomy for gall stone diseases gained popularity in almost every surgical speciality. The efficacy of laparoscopic appendicectomy compared to the conventional technique is the subject of debate nowadays 5,6 .Laparoscopic appendectomy has been shown to be feasible and safe in randomized comparisons with open appendectomy.…”

Section: Introductionmentioning

confidence: 99%

A Comparative Analysis between Laparoscopic and Open Appendicectomy in A Rural Medical College Hospital

Prabakaran¹

2017

jmscr

View full text Add to dashboard Cite

Laparoscopic versus open surgery for complicated appendicitis in adults: a randomized controlled trial

Abstract: These results suggested that LA for CA is safe and feasible, while the distinguishing benefit of LA was not validated in this clinical trial.

Cited by 71 publications

References 37 publications

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study

Use of Polymeric Clip (Hem-O-Lock) for Appendiceal Stump Ligation as a Favorable Technique in Laparoscopic Appendectomy

A Comparative Analysis between Laparoscopic and Open Appendicectomy in A Rural Medical College Hospital

Contact Info

Product

Resources

About