Laparoscopic versus open appendectomy: Which way to go?

doi:10.3748/wjg.14.4909

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Aug 21, 2008; 14(31): 4909-4914
Published online Aug 21, 2008. doi: 10.3748/wjg.14.4909

Laparoscopic versus open appendectomy: Which way to go?

Ioannis Kehagias, Stavros Nikolaos Karamanakos, Spyros Panagiotopoulos, Konstantinos Panagopoulos, Fotis Kalfarentzos

Ioannis Kehagias, Stavros Nikolaos Karamanakos, Spyros Panagiotopoulos, Konstantinos Panagopoulos, Fotis Kalfarentzos, Department of Surgery, School of Medicine, University Hospital of Patras, Rion University Hospital, Patras 26500, Greece

Author contributions: Kehagias I and Kalfarentzos F designed the study, Panagiotopoulos S and Panagopoulos K performed the research and Karamanakos SN wrote the paper.

Correspondence to: Ioannis Kehagias, MD, Department of Surgery, School of Medicine, University of Patras, Rion University Hospital, Patras 26500, Greece. stkarama@yahoo.gr

Telephone: +30-2610-999299 Fax: +30-2610-993984

Received: February 20, 2008
Revised: April 16, 2008
Accepted: April 23, 2008
Published online: August 21, 2008

Abstract

AIM: To compare the outcome of laparoscopic versus open appendectomy.

METHODS: Prospectively collected data from 293 consecutive patients with acute appendicitis were studied. These comprised of 165 patients who underwent conventional appendectomy and 128 patients treated laparoscopically. The two groups were compared with respect to operative time, length of hospital stay, postoperative pain, complication rate and cost.

RESULTS: There were no statistical differences regarding patient characteristics between the two groups. Conversion to laparotomy was necessary in 2 patients (1.5%). Laparoscopic appendectomy was associated with a shorter hospital stay (2.2 d vs 3.1 d, P = 0.04), and lower incidence of wound infection (5.3% vs 12.8%, P = 0.03). However, in patients with complicated disease, intra-abdominal abscess formation was more common after laparoscopic appendectomy (5.3% vs 2.1%, P = 0.002). The operative time and analgesia requirements were similar in the two groups. The cost of treatment was higher by 370 € in the laparoscopic group.

CONCLUSION: Laparoscopic appendectomy is as safe and efficient as open appendectomy, provided surgical experience and equipment are available.

Keywords: Laparoscopy; Appendicitis; Appendectomy; Conventional appendectomy