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KMID : 0978820080110010021
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2008 Volume.11 No. 1 p.21 ~ p.24
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Laparoscopic versus Open Appendectomy for Appendiceal Abscess
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Oh Chang-Hyun
Kim Ji-Il
Cho Hang-Joo
Kim Kee-Hwan
Kim Jeong-Soo
Yoo Seong-Jin
Lim Keun-Woo
An Chang-Hyeok
Kang Ki-Chang
Choi Jae-Young
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Abstract
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Purpose: Laparoscopic appendectomy has been widely applied in cases of uncomplicated appendicitis. Some recent studies have also reported that laparoscopic appendectomy could be the initial procedure of choice for patients suffering from complicated appendicitis. However, in cases of appendiceal abscess-as opposed to gangrenous or perforated appendicitis-the laparoscopic approach is very challenging because of severe adhesions and anatomical deterioration. The authors investigated the feasibility of using a laparoscopic approach in treating appendiceal abscesses.
Methods: We studied patients who underwent appendectomy by either laparoscopic or open technique at Uijongbu St. Mary’s Hospital between January and December 2007. There were 32 patients in the laparoscopic appendectomy (LA) group and 28 patients in the open appendectomy (OA) group. Patient demographic data and perioperative outcomes for the two groups were compared.
Results: Both patient groups were comparable with regard to age and gender. The mean operative time was significantly longer in the LA group than in the OA group (126 vs 108 minutes, respectively) (p=0.024). The mean hospital stay was significantly shorter in the LA group than in the OA group (6.3 vs 8.5 days, respectively) (p=0.001). The time to first meal was also significantly shorter in the LA group than in the OA group (2.9 vs 3.9 days, respectively) (p＜0.001). Complications including wound infection and wound seroma were significantly less frequent in the LA group than in the OA group. There was 1 (3.4%) wound problem in the LA group, and there were 7 (25%) wound problems in the OA group (p=0.019). Intraabdominal abscesses were comparable in frequency between the LA group and the OA group. The conversion rate was 9.3%.
Conclusion: LA for appendiceal abscess is feasible and safe. It is associated with a shorter hospital stay, earlier start of soft diet, and lower wound problem rate compared to OA. However, it requires a longer operative time compared to OA.
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KEYWORD
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Appendiceal abscess, Laparoscopic appendectomy
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