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World Journal of Emergency Surgery
Published in: World Journal of Emergency Surgery 1/2016

Open Access 01-12-2016 | Research article

Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness

Authors: Antonio Biondi, Carla Di Stefano, Francesco Ferrara, Angelo Bellia, Marco Vacante, Luigi Piazza

Published in: World Journal of Emergency Surgery | Issue 1/2016

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Abstract

Background

Appendectomy is the most common surgical procedure performed in emergency surgery. Because of lack of consensus about the most appropriate technique, appendectomy is still being performed by both open (OA) and laparoscopic (LA) methods. In this retrospective analysis, we aimed to compare the laparoscopic approach and the conventional technique in the treatment of acute appendicitis.

Methods

Retrospectively collected data from 593 consecutive patients with acute appendicitis were studied. These comprised 310 patients who underwent conventional appendectomy and 283 patients treated laparoscopically. The two groups were compared for operative time, length of hospital stay, postoperative pain, complication rate, return to normal activity and cost.

Results

Laparoscopic appendectomy was associated with a shorter hospital stay (2.7 ± 2.5 days in LA and 1.4 ± 0.6 days in OA), with a less need for analgesia and with a faster return to daily activities (11.5 ± 3.1 days in LA and 16.1 ± 3.3 in OA). Operative time was significantly shorter in the open group (31.36 ± 11.13 min in OA and 54.9 ± 14.2 in LA). Total number of complications was less in the LA group with a significantly lower incidence of wound infection (1.4 % vs 10.6 %, P <0.001). The total cost of treatment was higher by 150 € in the laparoscopic group.

Conclusion

The laparoscopic approach is a safe and efficient operative procedure in appendectomy and it provides clinically beneficial advantages over open method (including shorter hospital stay, decreased need for postoperative analgesia, early food tolerance, earlier return to work, lower rate of wound infection) against only marginally higher hospital costs.

Trial registration

NCT02867072 Registered 10 August 2016. Retrospectively registered.
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Metadata
Title
Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness
Authors
Antonio Biondi
Carla Di Stefano
Francesco Ferrara
Angelo Bellia
Marco Vacante
Luigi Piazza
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2016
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/s13017-016-0102-5

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