Laparoscopic appendectomy (L. A) was first described by Kurt Semm, German gynecologist, in 1983. At early times, it was limited to incidental appendectomy performed during gynecologic laparoscopy or to appendectomy for chronic appendicitis.
Since early 1990s, this procedure has been suggested as an alternative to conventional appendectomy (C.A) by many laparoscopic surgeons.
We reviewed our early experience of 75 L. A. s performed during 7 months from November 1992 to June 1993 and compared its results with those of 150 C. A. s performed during 9 months from September 1992 to June 1993 to assess the merits and
demerits
of
L. A.
@ES The results were as follows:
@EN 1) The 2 groups were not different significantly with regard to sex and age.
The rations of male to female were 1:1.08 in L. A. group and 1:1.03 in C. A. group.
The mean ages were 25.9 years in I. A. group and 27.3 years in C. A. group.
2) The pathologic severity was not different significantly between 2 group.
The cases of complicated appendicitis were 43% in L. A. group and 47% in C. A. group.
3) The mean operative time was longer in L. A. group.
The mean operative times were 69 minutes in L. A. group and 48 minutes in C. A. group (P<0.0001).
4) The mean hospital stays were shorter in L. A. group
The mean hospital stays were d4.2 days in L. A. group and 7.5 days in C. A. group (P<0.0001).
5) The mean periods of return to normal activity were shorter in L. A. group
The mean postoperative periods for normal activity were 6.2 days in L. A. group and 12.7 days in C. A. group (P<0.0001).
6) The postoperative wound complications were 1 case (1.3%) in L. A. group and 9 cases (6%) in C. A. group
7) The use of postoperative analgesics was less frequent in L. A. group.
The postoperative analgesics were used in 15 cases (20%) in L. A. group and 39 cases (26%) in C. A. group.
8) The postoperative readmission or reoperation was none in L. A. group, but reoperation was needed in one case of C. A. group.
9) The conversion to open laparotomy was needed in 1 case during the period of 75 L. A. s. (conversion rate : 1.3%)
In conclusion, we think that L. A is a safe, effective, cosmetic and less invasive alternative to the standard open technique.
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