|
KMID : 0978820030060010049
|
|
Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2003 Volume.6 No. 1 p.49 ~ p.54
|
|
|
Laparoscopic Appendectomy Increased Unnecessary Operation Compared with Open Appendectomy
|
|
Lee Hwan-Bong
Lee Jai-Kyoo
Lee Byung-Chan
|
|
|
Abstract
|
|
|
Purpose: Laparoscopic appendectomy (LA) is accepted world widely as the first choice of treatment in suspected appendicitis. Its rationale is rapid and favorable recovery in many reports even in complicated appendicitis also, for which some surgeons, however, are reluctant to agree with. We have been performing LA by one surgeon and open appendectomy (OA) by another at the same period to compare above issue prospectively between each other.
Methods: During one year from July 1998, 155 each cases of LA and OA performed by each surgeon were chart reviewed in view of missed diagnoses and clinical courses including complications. Patients were assigned to each surgeon alternatively as they arrive after decision of operation though discussion.
Results: One hundred fifty-five LA included 33 (21.3%) cases of operations from other than appendicitis, among which 27 cases (17.4%) was unnecessarily operated, while OA showed 24 cases (15.4%) of other pathologies where 15 operations (9.7%) were unnecessary. Sixteen cases (10.3%) were converted from LA to OA due to technical difficulty leading to delayed operation time and recovery course (p＜0.05), with 3 misdiagnoses and 2 unnecessary operations in them.
Conclusion: Trial of LA induced the surgeon to determine operation more easily, leading to more frequent unnecessary operations (p＜0.05), and prolonging operation and recovery time in converted cases. Higher rate of unnecessary operation by LA should always be kept in mind when deciding whether to operate by LA or OA.
|
|
|
KEYWORD
|
|
|
Appendicitis, Laparoscope, Unnecessary laparotomy
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
 
|