Open Versus Laparoscopic Appendectomy A Prospective Randomized Comparison

Martin, Ludmila Katherine; Puente, Ivan; Sosa, Jorge; Bassin, Alan; Breslaw, Ralph; McKenney, Mark; Ginzburg, Enrique; Sleeman, Danny

doi:10.1097/00000658-199509000-00004

Cited by 230 publications

(159 citation statements)

References 15 publications

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“…Most of the study also reported that postoperative complications are more related to severity of underlying pathology than the type of procedure. 9,16 The results demonstrate a significantly earlier return to full activity for laparoscopic than open appendectomy. This is parallel with the results shown by other research worker in most of the studies.…”

Section: Figure 1: Hospital Staymentioning

confidence: 82%

Comparison of open versus laparoscopic appendectomy

Kumar¹,

Aggarwal²

2018

Int J Res Med Sci

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Background: Although laparoscopic cholecystectomy has now considered the gold standard for the management of gall stone disease, laparoscopic appendectomy has not attained the same degree of popularity and acceptance. Aim of this study is to assess and compare the role of laparoscopic appendectomy with open appendectomy in acute appendicitis as well as in the patients planned for interval appendectomy.Methods: Total number of fifty cases over the age of 12 years were studied prospectively. Out of 50 number of total cases, 20 cases were those who have been operated laparoscopically while 30 cases were of open appendectomy group. The two groups were compared with respect to operative time, length of hospital stay, post-operative pain and nausea, complication rate and time to return to normal activity.Results: The mean age was 22.8±2(6.83) and 26.7±2(9.22) years in the laparoscopic and open groups respectively, with the range of 14 to 42 in the laparoscopic group and 13 to 50 years in the open group. The Average operating time was more in the laparoscopic appendectomy as compared to the time taken in performing open appendectomy. However, this was not statistically significant with p<0,05. Overall, there was no significant difference in the incidence of complications between open and laparoscopic groups.Conclusions: The laparoscopic appendectomy is safe, simple and efficient technique for treatment of acute appendicitis with result comparable to the open appendectomy, if not better.

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Section: Figure 1: Hospital Staymentioning

confidence: 82%

Comparison of open versus laparoscopic appendectomy

Kumar¹,

Aggarwal²

2018

Int J Res Med Sci

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“…Pneumoperitoneum during a laparoscopic appendicectomy also increases the risk of general anesthesia-related complications in elderly patients (8). Furthermore, 10% of laparoscopic surgeries may need conversion to open appendicectomies, mainly with highgrade inflammation (9,10).…”

Section: Discussionmentioning

confidence: 99%

‘surface map’ of appendix – a novel tool for pre-operative demonstration of appendicular location with reference to mcburney’s point using multi-detector ct.

Ghonge¹,

Setia²,

Aggarwal³

2012

Diagn Interv Radiol

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According to conventional teaching in surgical practice, McBurney's point is the anatomical landmark for locating the appendix and is commonly described as the junction of the lateral and middle thirds of the line joining the right anterior superior iliac spine and the umbilicus (1). Several studies have, however, suggested a significant discrepancy between the McBurney's point and the exact anatomical location of the appendix (2, 3). Multidetector computed tomography (MDCT) is a "one-stop" imaging solution for effective diagnosis of acute appendicitis, with a sensitivity and specificity ranging from 87%−100% and 89%−99%, respectively (4). Similar to the way surgeons use McBurney's point to decide the site of an open appendicectomy incision, the MDCT "surface map" provides a representation of the appendicular base over the anterior abdominal wall in a single image.The present study evaluated the role of MDCT "surface mapping" of the appendix in demonstrating the variation in the location of the appendicular base with reference to McBurney's point and also to anticipate the surgical implications of these results in patients with acute appendicitis. Materials and methodsThis prospective study included a total of 74 patients who had MDCT (Somatom Sensation Cardiac 64 CT scanner, Siemens AG Healthcare, Erlangen, Germany) of the abdomen for varied clinical indications over a period of two months. Patients with a clinical history of any abdominal surgery, systemic malignancy, radiotherapy, or tuberculosis were excluded. A contrast-enhanced CT study of the abdomen was performed in venous phase with a data acquisition time of 6.15 s, scan delay of 60 s, beam collimation of 0.6 mm, gantry rotation time of 0.5 s, and pitch of 1.15. The peak tube voltage range was 100−120 kV, and the current range was 180-225 mAs, using the "care-dose" technique. The images were reconstructed at 3 mm thicknesses in the axial, sagittal, and coronal planes. Because the study did not affect the routine filming and reporting pattern, no ethical approval was required. Post-processing of the MDCT data was performed using the INSPACE software (Siemens AG Healthcare) and a "surface map" was reconstructed with a superimposed measurement grid. The software utilized the volume rendering technique (VRT) of MDCT. A detailed step-wise algorithm with explanatory images is shown in Fig. 1. An illustrative MDCT "surface map" is shown in Fig. 2. The "zero" of the measurement grid corresponded to the umbilicus on the "surface map" image. Post-processing was performed by a single CT technologist, under the direct supervision of the radiologist. The variations in the location of the appendicular base with reference to McBurney's point were tabulated along the cranio-caudal and medio-lateral axes. The location of the appendicular base along MATERIALS AND METHODSThis prospective study included a total of 74 patients who underwent an MDCT study of the abdomen for various clinical indications. Post-processing of the data was performed and a "surface map" of the a...

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“…Relative to conventional surgery, laparoscopy reduces postoperative pain and the hospital stay, and allows the patient to resume normal activities more rapidly [9,10]. However, it remains controversial because of the lengthy surgery, the relatively high morbidity, and problems in respecting oncological principles in this setting.…”

Section: Discussionmentioning

confidence: 99%

“…en bloc removal of the kidney, adrenal gland, Gerota's fascia and pararenal fat [3][4][5]. Laparoscopic RN (LRN) can be preformed either by the transperitoneal [6] or retroperitoneal approach [7][8][9]. In our institution we initially used LRN by the retroperitoneal approach; in the present study we compared the results of retroperitoneal LRN with open RN in patients with T1 lesions.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic radical nephrectomy for T1 renal cancer: the gold standard? A comparison of laparoscopic vs open nephrectomy

et al. 2003

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recurrence, were compared between the groups. RESULTSThere were no differences between the laparoscopic and open groups in age, sex ratio, weight, height, fitness score, operative duration (134 vs 133 min), minor or major complications, tumour diameter, Fuhrman grade or length of follow-up. Patients who underwent laparoscopic surgery had less blood loss (133 vs 357 mL, P < 0.001), less need for transfusion (none vs 150 mL, P = 0.04), a lower consumption of analgesia drugs, and shorter hospitalization (5.5 vs 8.8 days, P < 0.001). With a mean follow-up of 20.4 months there was no recurrence or tumour progression. CONCLUSIONLaparoscopic radical nephrectomy for patients with T1 renal cancer is a safe, reliable procedure that decreases hospitalization time and bleeding, and ensures the same cancer control as open nephrectomy.

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Open Versus Laparoscopic Appendectomy A Prospective Randomized Comparison

Cited by 230 publications

References 15 publications

Comparison of open versus laparoscopic appendectomy

Comparison of open versus laparoscopic appendectomy

‘surface map’ of appendix – a novel tool for pre-operative demonstration of appendicular location with reference to mcburney’s point using multi-detector ct.

Laparoscopic radical nephrectomy for T1 renal cancer: the gold standard? A comparison of laparoscopic vs open nephrectomy

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