We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Comparison of clinical outcome of laparoscopic versus open appendectomy for complicated appendicitis.
- Authors
Horvath, P.; Lange, J.; Bachmann, R.; Struller, F.; Königsrainer, A.; Zdichavsky, M.; Königsrainer, A
- Abstract
<bold>Background: </bold>Laparoscopic appendectomy is now the treatment of choice in uncomplicated appendicitis. To date its importance in the treatment of complicated appendicitis is not clearly defined.<bold>Methods: </bold>From January 2005 to June 2013 a total of 1762 patients underwent appendectomy for the suspected diagnosis of appendicitis at our institution. Of these patients 1516 suffered from complicated appendicitis and were enrolled. In total 926 (61 %) underwent open appendectomy (OA) and 590 (39 %) underwent laparoscopic appendectomy (LA). The following parameters were retrospectively analyzed: age, sex, operative times, histology, length of hospital stay, 30-day morbidity focusing on occurrence of surgical site infections, intraabdominal abscess formation, postoperative ileus and appendiceal stump insufficiency, conversion rate, use of endoloops and endostapler.<bold>Results: </bold>A statistically significant difference in operative time was observed between the laparoscopic and the open group (64.5 vs. 60 min; p = 0.002). Median length of hospitalization was significantly shorter in the laparoscopic group (p < 0.000). Surgical site infections occurred exclusively after OA (38 vs. 0 patients). Intraabdominal abscess formation occurred statistically significantly more often after LA (2 vs. 10 patients; p = 0.002). There were no statistical significances concerning the occurrence of postoperative ileus (p = 0.261) or appendiceal stump insufficiencies (p = 0.076).<bold>Conclusions: </bold>The laparoscopic approach for complicated appendicitis is a safe and feasible procedure. Surgeons should be aware of a potentially higher incidence of intraabdominal abscess formation following LA. Use of endobags , inversion of the appendiceal stump and carefully conducted local irrigation of the abdomen in a supine position may reduce the incidence of abscess formation.
- Subjects
HEALTH outcome assessment; APPENDECTOMY; APPENDICITIS diagnosis; APPENDICITIS treatment; LAPAROSCOPIC surgery; ABSCESSES
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2017, Vol 31, Issue 1, p199
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-016-4957-z