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KMID : 0356720110270060293
Journal of the Korean Society of Coloproctology
2011 Volume.27 No. 6 p.293 ~ p.297
A Clinical Comparison of Laparoscopic versus Open Appendectomy for Complicated Appendicitis
Lim Sun-Gu

Ahn Eun-Jung
Kim Seong-Yup
Chung Il-Yong
Park Jong-Min
Park Sei-Hyeog
Choi Kyoung-Woo
Abstract
Purpose: Although laparoscopic appendectomies (LAs) are performed universally, a controversy still exists whether the LA is an appropriate surgical approach to complicated appendicitis (CA). We retrospectively evaluated the outcomes of laparoscopic versus open appendectomies for CA.

Methods: Although laparoscopic appendectomies (LAs) are performed universally, a controversy still exists whether the LA is an appropriate surgical approach to complicated appendicitis (CA). We retrospectively evaluated the outcomes of laparoscopic versus open appendectomies for CA.

Results: There were no statistically significant differences in operative time between the LA and the open appendectomy (OA) groups. Return to soft diet was faster in the LA group (2.1 ¡¾ 1.2 vs. 3.5 ¡¾ 1.5 days; P = 0.001). Length of hospital stay was shorter for the LA group (4.4 ¡¾ 2.3 vs. 5.8 ¡¾ 2.9 days; P = 0.045). The overall complication rates showed no statistically significant difference between the two groups. In cases involving a periappendiceal abscess, the LA had a significantly higher incidence of intra-abdominal abscess (IAA) and postoperative ileus (PI; P = 0.028).

Conclusion: The LA showed good results in terms of the time to soft diet, the length of hospital stay, and surgical site infection (SSI) whereas the overall complication rates were similar for the two groups. However, the LA was associated with significantly higher incidence of IAA and PI for the cases with a periappendiceal abscess. Therefore, when using a LA, the surgeon must take great care to minimize the incidence of IAA and PI if a periappendiceal abscess is present.
KEYWORD
Complicated appendicitis, Laparoscopic appendectomy, Open appendectomy
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