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KMID : 0365719960120010064
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Journal of Pusan Surgical Society
1996 Volume.12 No. 1 p.64 ~ p.73
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A Clinical Comparative Analysis of Laparoscpic versus Open Appendectomy
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Abstract
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The results of recent series suggest remarkable advantages of laparoscopic appendectomy over the conventional open appendectomy. To determine if clear advantages could be established, the records of patients operated on under a presumptive
diagnosis of
acute appendicitis were retrospectively reviewed.
From May 1995 through June 1996, 235 conventional open appendectomies and 101 laparoscopic appendectomies were performed. We randomly sampled 100 cases from 235 open appendectomies and compared data from both groups with respect to age and sex,
pathologic findings, operative times, complication, duration of ileus, hospital stay, and cost.
1) There was no significant difference in the age distribution between both groups. The male/female ratio of laparoscopic group (1 : 1.8) was significantly lower than that of open appendectomy (1.7 : 1) (p = 0.001).
2) Laparoscopic appendectomy was performed in any pathologic types of appendicitis as with open appendectomy (p>0.05), and the rates of misdiagnosis in both groups were similar (p=0.628).
3) Laparoscopic appendectomy took a mean time of 55.4±19.8 minutes, open appendectomy took 44.4±14.8 minutes. There was a statistical difference between both groups (p=0.0001).
4) The incidences of postoperative complications in both groups were similar. The frequent complications of laparoscopic appendectomy were intra-abdominal abscess, hemorrhage, and subcutaneous emphysema.
5) The mean duration of ileus of laparoscopic appendectomy (1.4±0.6 days) was statistically shorter than that of open appendectomy (1.7±0.7 days) (p=0.0009).
6) The duration of hopsital stay of laparoscopic appendectomy (5.3±1.5 days) was statistically shorter than that of open appendectomy (7.2±1.6 days) (p<0.001).
7) The mean cost of laparoscopic appendectomy (550.625±72.747 won) was more expensive than that of open appendectomy (294.125±68.018 won).
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