While the role and effect of laparoscopic cholecystectomy is well established, that of laparoscopic appendectomy has not been objectively defined. We designed this study to compare the result of laparoscppic(LA) and open appendectomy(OA) as a
treatment
for suspected acute appendicitis.
Among a total of 187 consecutive patients, 156 patients were used in this study, excluding those cases diagnosed as other diseases postoperatively. Grouping was done as LA grop(n=56) and OA group(n=100). Both groups were subdivided into
non-complicated
and complicated forms, and compared with respect to 7 parameters; anesthetic time, operative time, duration of hospital stay, duration of ileus, frequency of postoperative analgesia, complication rate, and cosmetic result of the operative wound.
Postoperative diagnosis was also analyzed.
The mean anesthetic time was longer in the LA group (p<0.05), although operative time was the same. The hospital stay was shorter in the LA group(p<0.05). The LA group spent less time recovering normal bowel activity(p<0.05) and required less
postoperative analgesia(p<0.05). These were, however, not clinically obvious, because the postoperative course of open appendectomy was not protracted. The cosmetic result of the operative wound was much better and three were fewer complications
in
the
LA group Other diagnoses were more frequently found in LA patients.
]In conclusion, one cannot assert LA to be the treatment of choice for acute appendicitis, because conventional open appendectomy is a relatively small surgery in itself. Nevertheless, LA may be a good substitute for OA in selected cases, such as
in
female patient of reproductive age.
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