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Published in: Surgical Endoscopy 6/2006

01-06-2006 | Original Article

Laparoscopic appendectomy in the elderly

Authors: Y.-C. Wang, H.-R. Yang, P.-K. Chung, L.-B. Jeng, R.-J. Chen

Published in: Surgical Endoscopy | Issue 6/2006

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Abstract

Background

This study aimed to compare the outcomes of laparoscopic and open appendectomy among the elderly.

Methods

Data on 53 elderly patients with a diagnosis of suspected appendicitis were prospectively collected and retrospectively reviewed. Among these patients, 24 had undergone laparoscopic appendectomy (LA) and 29 had undergone open appendectomy (OA). The indications for either method were based on the patient’s choice.

Results

No statistically significant difference in operative time was found between the LA (70 ± 28 min) and OA (60 ± 22 min) groups. There was no statistically significant difference in lengths of hospital stay between the LA (4.8 ± 3.0 days) and OA (5.0 ± 3.1 days) groups, and there was a statistically significant difference in the postoperative analgesic doses between the LA (0.5 ± 0.3 doses) and OA (1.7 ± 1.5 doses) groups. No conversion of laparoscopic to open surgery was necessary, and no intraabdominal abscesses developed.

Conclusion

According to this study, LA is as safe and effective as OA for the elderly. Furthermore, it significantly reduces postoperative wound pain.
Literature
1.
go back to reference Attwood SE, Hill AD, Murphy PG., Thornton J, Stephens RB (1992) A prospective randomized trial of laparoscopic versus open appendectomy. Surgery 112: 497–501PubMed Attwood SE, Hill AD, Murphy PG., Thornton J, Stephens RB (1992) A prospective randomized trial of laparoscopic versus open appendectomy. Surgery 112: 497–501PubMed
2.
go back to reference Butler C (1981) Surgical pathology of acute appendicitis. Hum Pathol 12: 870PubMed Butler C (1981) Surgical pathology of acute appendicitis. Hum Pathol 12: 870PubMed
3.
go back to reference Franz MG, Norman J, Fabri PJ (1995) Increased morbidity of appendicitis with advancing age. Am Surg 61: 40–44PubMed Franz MG, Norman J, Fabri PJ (1995) Increased morbidity of appendicitis with advancing age. Am Surg 61: 40–44PubMed
4.
go back to reference Frazee RC, Bohannon WT (1996) Laparoscopic appendectomy for complicated appendicitis. Arch Surg 131: 509–511PubMed Frazee RC, Bohannon WT (1996) Laparoscopic appendectomy for complicated appendicitis. Arch Surg 131: 509–511PubMed
5.
go back to reference Frazee RC, Roberts JW, Symmonds RE, Snyder SK, Hendricks JC, Smith RW, Custer MD III, Harrison JB (1994) A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg 219: 725–728PubMed Frazee RC, Roberts JW, Symmonds RE, Snyder SK, Hendricks JC, Smith RW, Custer MD III, Harrison JB (1994) A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg 219: 725–728PubMed
6.
go back to reference Galizia G, Prizio G, Lieto E, Castellano P, Pelosio L, Imperatore V, Ferrara A, Pignatelli C (2001) Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum, and abdominal wall–lifting cholecystectomy: a prospective, randomized study. Surg Endosc 15: 477–483PubMedCrossRef Galizia G, Prizio G, Lieto E, Castellano P, Pelosio L, Imperatore V, Ferrara A, Pignatelli C (2001) Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum, and abdominal wall–lifting cholecystectomy: a prospective, randomized study. Surg Endosc 15: 477–483PubMedCrossRef
7.
go back to reference Guller U, Jain N, Peterson ED, Muhlbaier LH, Eubanks S, Pietrobon R (2004) Laparoscopic appendectomy in the elderly. Surgery 135: 479–488PubMedCrossRef Guller U, Jain N, Peterson ED, Muhlbaier LH, Eubanks S, Pietrobon R (2004) Laparoscopic appendectomy in the elderly. Surgery 135: 479–488PubMedCrossRef
8.
go back to reference Gurleyik G, Gurleyik E (2003) Age-related clinical features in older patients with acute appendicitis. Eur J Emerg Med 10: 200–203PubMedCrossRef Gurleyik G, Gurleyik E (2003) Age-related clinical features in older patients with acute appendicitis. Eur J Emerg Med 10: 200–203PubMedCrossRef
9.
go back to reference Hansen JB, Smithers BM, Schache D, Wall DR, Miller BJ, Menzies BL (1996) Laparoscopic versus open appendectomy: prospective randomized trial. World J Surg 20: 17–20PubMedCrossRef Hansen JB, Smithers BM, Schache D, Wall DR, Miller BJ, Menzies BL (1996) Laparoscopic versus open appendectomy: prospective randomized trial. World J Surg 20: 17–20PubMedCrossRef
10.
go back to reference Hardin D (1999) Acute appendicitis: review and update. Am Fam Phys 60: 2027–2036 Hardin D (1999) Acute appendicitis: review and update. Am Fam Phys 60: 2027–2036
11.
go back to reference Ho HS, Gunther RA, Wolfe BM (1992) Intraperitoneal carbon dioxide insufflation and cardiopulmonary functions. Arch Surg 127: 928–933PubMed Ho HS, Gunther RA, Wolfe BM (1992) Intraperitoneal carbon dioxide insufflation and cardiopulmonary functions. Arch Surg 127: 928–933PubMed
12.
go back to reference Hui TT, Major KM, Avital I, Hiatt JR, Margulies DR (2002) Outcome of elderly patients with appendicitis: effect of computed tomography and laparoscopy. Arch Surg 137: 995–998PubMedCrossRef Hui TT, Major KM, Avital I, Hiatt JR, Margulies DR (2002) Outcome of elderly patients with appendicitis: effect of computed tomography and laparoscopy. Arch Surg 137: 995–998PubMedCrossRef
13.
go back to reference Ignacio RC, Burke R, Spencer D, Bissell C, Dorsainvil C, Lucha PA (2004) Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc 18: 334–337PubMedCrossRef Ignacio RC, Burke R, Spencer D, Bissell C, Dorsainvil C, Lucha PA (2004) Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc 18: 334–337PubMedCrossRef
14.
go back to reference Kazemier G, de Zeeuw GR, Lange JF, Hop WC, Bonjer HJ (1997) Laparoscopic vs open appendectomy: a randomized clinical trial. Surg Endosc 11: 336–340PubMedCrossRef Kazemier G, de Zeeuw GR, Lange JF, Hop WC, Bonjer HJ (1997) Laparoscopic vs open appendectomy: a randomized clinical trial. Surg Endosc 11: 336–340PubMedCrossRef
15.
go back to reference Lau WY, Fan ST, Yiu TF, Chu KW, Lee JM (1985) Acute appendicitis in the elderly. Surg Gynecol Obstet 161: 157–160PubMed Lau WY, Fan ST, Yiu TF, Chu KW, Lee JM (1985) Acute appendicitis in the elderly. Surg Gynecol Obstet 161: 157–160PubMed
16.
17.
go back to reference Liu SY, Leighton T, Davis I, Klein S, Lippmann M, Bongard F (1991) Prospective analysis of cardiopulmonary responses to laparoscopic cholecystectomy. J Laparoendosc Surg 1: 241–246PubMed Liu SY, Leighton T, Davis I, Klein S, Lippmann M, Bongard F (1991) Prospective analysis of cardiopulmonary responses to laparoscopic cholecystectomy. J Laparoendosc Surg 1: 241–246PubMed
18.
go back to reference Lo CM, Lai EC, Fan ST, Liu CL, Wong J (1996) Laparoscopic cholecystectomy for acute cholecystitis in the elderly. World J Surg 20: 983–987PubMedCrossRef Lo CM, Lai EC, Fan ST, Liu CL, Wong J (1996) Laparoscopic cholecystectomy for acute cholecystitis in the elderly. World J Surg 20: 983–987PubMedCrossRef
19.
go back to reference Magnuson TH, Ratner LE, Zenilman ME, Bender JS (1997) Laparoscopic cholecystectomy: applicability in the geriatric population. Am Surg 63: 91–96PubMed Magnuson TH, Ratner LE, Zenilman ME, Bender JS (1997) Laparoscopic cholecystectomy: applicability in the geriatric population. Am Surg 63: 91–96PubMed
20.
go back to reference McBurney C (1894) The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg 20: 38–43PubMedCrossRef McBurney C (1894) The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg 20: 38–43PubMedCrossRef
21.
go back to reference Merhoff AM, Merhoff GC, Franklin ME (2000) Laparoscopic versus open appendectomy. Am J Surg 179: 375–378PubMedCrossRef Merhoff AM, Merhoff GC, Franklin ME (2000) Laparoscopic versus open appendectomy. Am J Surg 179: 375–378PubMedCrossRef
22.
go back to reference Paik PS, Towson JA, Anthone GJ, Ortega AE, Simons AJ, Beart RW Jr (1997) Intraabdominal abscesses following laparoscopic and open appendectomies. J Gastrointest Surg 1: 188–193PubMedCrossRef Paik PS, Towson JA, Anthone GJ, Ortega AE, Simons AJ, Beart RW Jr (1997) Intraabdominal abscesses following laparoscopic and open appendectomies. J Gastrointest Surg 1: 188–193PubMedCrossRef
23.
go back to reference Peltokallio P, Tykka H (1981) Evolution of the age distribution and mortality of acute appendicitis. Arch Surg 116: 153–156PubMed Peltokallio P, Tykka H (1981) Evolution of the age distribution and mortality of acute appendicitis. Arch Surg 116: 153–156PubMed
24.
go back to reference Piskun G, Kozik D, Rajpal S, Shaftan G, Fogler R (2001) Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis. Surg Endosc 15: 660–662PubMedCrossRef Piskun G, Kozik D, Rajpal S, Shaftan G, Fogler R (2001) Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis. Surg Endosc 15: 660–662PubMedCrossRef
26.
go back to reference So JB, Chiong EC, Chiong E, Cheah WK, Lomanto D, Goh P, Kum CK (2002) Laparoscopic appendectomy for perforated appendicitis. World J Surg 26: 1485–1488PubMedCrossRef So JB, Chiong EC, Chiong E, Cheah WK, Lomanto D, Goh P, Kum CK (2002) Laparoscopic appendectomy for perforated appendicitis. World J Surg 26: 1485–1488PubMedCrossRef
27.
go back to reference Yamini D, Vargas H, Bongard F, Klein S, Stamos MJ (1995) Perforated appendicitis: is it truly a surgical urgency? Am Surg 221: 279–282 Yamini D, Vargas H, Bongard F, Klein S, Stamos MJ (1995) Perforated appendicitis: is it truly a surgical urgency? Am Surg 221: 279–282
Metadata
Title
Laparoscopic appendectomy in the elderly
Authors
Y.-C. Wang
H.-R. Yang
P.-K. Chung
L.-B. Jeng
R.-J. Chen
Publication date
01-06-2006
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 6/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-005-0658-8

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