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World Journal of Surgery

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01-04-2007 | ORIGINAL SCIENTIFIC REPORTS

Complicated Appendicitis: Laparoscopic or Conventional Surgery?

Authors: Boris Kirshtein, Michael Bayme, FACS, Sergey Domchik, Solly Mizrahi, FACS, Leonid Lantsberg

Published in: World Journal of Surgery | Issue 4/2007

Abstract

Background

The surgical treatment of complicated appendicitis remains controversial. The aim of this study was to evaluate the role of laparoscopic appendectomy in the treatment of complicated appendicitis in comparison with open surgery.

Methods

We reviewed the medical records of all patients who underwent an appendectomy for complicated appendicitis between January 2001 and August 2005.

Results

We identified 98 patients with complicated appendicitis. Forty-eight patients underwent open appendectomy, 42 laparoscopic appendectomy, and 8 initial laparoscopy with conversion to open surgery. Older patients, patients with comorbidities, and female patients were more likely to have been offered a laparoscopic appendectomy. Operating time, time to solid oral intake, and time of hospital stay were prolonged in the laparoscopic group but not significantly. There was no mortality observed in either group, and the complication rate was similar in both groups.

Conclusions

Laparoscopic appendectomy is an acceptable procedure for complicated appendicitis, with the same rate of infectious complications as the conventional approach.

Chung RS, Rowland DY, Li P, Diaz J. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg 1999;177:250–256PubMedCrossRef

Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a metaanalysis. J Am Coll Surg 1998;186:545–553PubMedCrossRef

Peiser JG, Greenberg D. Laparoscopic versus open appendectomy: results of a retrospective comparison in an Israeli hospital. Isr Med Assoc J 2002;4:91–94PubMed

Long KH, Bannon MP, Zietlow SP, et al. A prospective randomized comparison of laparoscopic appendectomy with open appendectomy: Clinical and economic analyses. Surgery 2001;129:390–400PubMed

Krisher SL, Browne A, Dibbins A, et al. Intra-abdominal abscess after laparoscopic appendectomy for perforated appendicitis. Arch Surg 2001;136:438–441PubMedCrossRef

Paik PS, Towson JA, Anthone GJ, et al. Intra-abdominal abscesses following laparoscopic and open appendectomies. J Gastrointest Surg 1997;1:188–193PubMedCrossRef

Frazee RC, Bohannon WT. Laparoscopic appendectomy for complicated appendicitis. Arch Surg 1996;131:509–511; discussion 511–503PubMed

So JB, Chiong EC, Chiong E, et al. Laparoscopic appendectomy for perforated appendicitis. World J Surg 2002;26:1485–1488PubMedCrossRef

Johnson AB, Peetz ME. Laparoscopic appendectomy is an acceptable alternative for the treatment of perforated appendicitis. Surg Endosc 1998;12:940–943PubMedCrossRef

10.

Alvarez C, Voitk AJ. The road to ambulatory laparoscopic management of perforated appendicitis. Am J Surg 2000;179:63–66PubMedCrossRef

11.

Hart R, Rajgopal C, Plewes A, et al. Laparoscopic versus open appendectomy: a prospective randomized trial of 81 patients. Can J Surg 1996;39:457–462PubMed

12.

Katkhouda N, Mason RJ, Towfigh S, et al. Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg 2005;242:439–448; discussion 448–450PubMed

13.

Ortega AE, Hunter JG, Peters JH, et al. A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic Appendectomy Study Group. Am J Surg 1995;169:208–212; discussion 212–203PubMedCrossRef

14.

Piskun G, Kozik D, Rajpal S, et al. Comparison of laparoscopic, open, and converted appendectomy for perforated appendicitis. Surg Endosc 2001;15:660–662PubMedCrossRef

15.

Navez B, Delgadillo X, Cambier E, et al. Laparoscopic approach for acute appendicular peritonitis: efficacy and safety: a report of 96 consecutive cases. Surg Laparosc Endosc Percutan Tech 2001;11:313–316PubMedCrossRef

16.

Khalili TM, Hiatt JR, Savar A, et al. Perforated appendicitis is not a contraindication to laparoscopy. Am Surg 1999;65:965–967PubMed

17.

Katkhouda N, Friedlander MH, Grant SW, et al. Intraabdominal abscess rate after laparoscopic appendectomy. Am J Surg 2000;180:456–459; discussion 460–451PubMedCrossRef

18.

Marzouk M, Khater M, Elsadek M, Abdelmoghny A. Laparoscopic versus open appendectomy: a prospective comparative study of 227 patients. Surg Endosc 2003;17:721–724PubMedCrossRef

19.

Stoltzing H, Thon K. Perforated appendicitis: is laparoscopic operation advisable? Dig Surg 2000;17:610–616PubMedCrossRef

20.

Wullstein C, Barkhausen S, Gross E. Results of laparoscopic vs. conventional appendectomy in complicated appendicitis. Dis Colon Rectum 2001;44:1700–1705PubMedCrossRef

21.

Nguyen DB, Silen W, Hodin RA. Appendectomy in the pre- and postlaparoscopic eras. J Gastrointest Surg 1999;3:67–73PubMedCrossRef

22.

Helmer KS, Robinson EK, Lally KP, et al. Standardized patient care guidelines reduce infectious morbidity in appendectomy patients. Am J Surg 2002;183:608–613PubMedCrossRef

23.

Galizia G, Prizio G, Lieto E, et al. Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal wall-lifting cholecystectomy. A prospective, randomized study. Surg Endosc 2001;15:477–483PubMedCrossRef

24.

Bickel A, Yahalom M, Roguin N, et al. Power spectral analysis of heart rate variability during positive pressure pneumoperitoneum: the significance of increased cardiac sympathetic expression. Surg Endosc 2002;16:1341–1344PubMedCrossRef

25.

Reed DN Jr, Duff JL. Persistent occurrence of bradycardia during laparoscopic cholecystectomies in low-risk patients. Dig Surg 2000;17:513–517PubMedCrossRef

26.

Zollinger A, Krayer S, Singer T, et al. Haemodynamic effects of pneumoperitoneum in elderly patients with an increased cardiac risk. Eur J Anaesthesiol 1997;14:266–275PubMedCrossRef

27.

Kouwenhoven EA, van Driel OJ, van Erp WF. Fear for the intraabdominal abscess after laparoscopic appendectomy: not realistic. Surg Endosc 2005;19:923–926PubMedCrossRef

28.

Hellberg A, Rudberg C, Kullman E, et al. Prospective randomized multicentre study of laparoscopic versus open appendicectomy. Br J Surg 1999;86:48–53PubMedCrossRef

29.

Liu SI, Siewert B, Raptopoulos V, Hodin RA. Factors associated with conversion to laparotomy in patients undergoing laparoscopic appendectomy. J Am Coll Surg 2002;194:298–305PubMedCrossRef

30.

Katkhouda N, Mason RJ, Mavor E, et al. Laparoscopic finger-assisted technique (fingeroscopy) for treatment of complicated appendicitis. J Am Coll Surg 1999;189:131–133PubMedCrossRef

31.

Lee SL, Walsh AJ, Ho HS. Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis. Arch Surg 2001;136:556–562PubMedCrossRef

Title: Complicated Appendicitis: Laparoscopic or Conventional Surgery?
Authors: Boris Kirshtein
Michael Bayme, FACS
Sergey Domchik
Solly Mizrahi, FACS
Leonid Lantsberg
Publication date: 01-04-2007
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 4/2007
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-006-0467-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Complicated Appendicitis: Laparoscopic or Conventional Surgery?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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