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KMID : 0356719960120020213
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Journal of the Korean Society of Coloproctology
1996 Volume.12 No. 2 p.213 ~ p.220
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A Comparative Study of Laparoscopic and Open Appendectomy
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Kim Jun-Geon
Rhee Jung-Ahn
Kim Sang-Youn
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Abstract
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Laparoscopic surgery is becoming an increasingly common phenomenon. Between January and December 1994, a total of 433 patients with suspected appendicitis were studied to compare 141 cases of laparoscopic and 292 cases of open appendectomies. Patients were not randomized:laparoscopic appendectomy was performed by a single laparoscopy-trained surgeon and patient selection was based on the patient’s decision and parental consent in children. Laparoscopic appendectomy was attempted in 153 patients and was successful in 141 (92.2%), and major cause of conversions to open operation was marked inflammatory adhesions around the appendix. The age, male to female ratio, and the severity of
appendicitis were similar in both groups. The operative time was longer in the laparoscopic group(54.9 minutes versus 49.6 minutes, p<0.05). The number of injections of analgesic required in the immediate postoperative period was less in patients with undergoing laparoscopic appendectomy(2.6 injections versus 4.6 injections, p<0.001). Diet was started earlier . after laparoscopic surgery(17.9 hours versus 57.1 hours, p<0.001). Postoperative hospital stay was shorter after laparoscopic surgery(2.8 days versus 6.5 days, p<0.001). There were no statistical differences in morbidity except wound infection which was significantly less frequent after laparoscopic appendectomy(1.4% versus 6.5%, p<0.05).
The present study suggests that laparoscopic appendectomy has a number of advantages over open appendectomy including decreased postoperative pain, early start of diet, low incidence of wound infection, and reduced hospital stay, although a randomized study is necessary. The authors consider laparoscopic appendectomy to be the procedure of choice for patients with suspected acute appendicitis if it is carried out by surgeons experienced in laparoscopic techniques.
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KEYWORD
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Laparoscopy, Appendicitis
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