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A Clinical Comparison of Laparoscopic versus Open Appendectomy for Complicated Appendicitis

대한대장항문학회지 2011년 27권 6호 p.293 ~ 297
 ( Lim Sun-Gu ) - National Medical Center Department of Surgery

 ( Ahn Eun-Jung ) - National Medical Center Department of Surgery
 ( Kim Seong-Yup ) - National Medical Center Department of Surgery
 ( Chung Il-Yong ) - National Medical Center Department of Surgery
 ( Park Jong-Min ) - National Medical Center Department of Surgery
 ( Park Sei-Hyeog ) - National Medical Center Department of Surgery
 ( Choi Kyoung-Woo ) - National Medical Center Department of Surgery

Abstract


Purpose: Although laparoscopic appendectomies (LAs) are performed universally, a controversy still exists whether the LA is an appropriate surgical approach to complicated appendicitis (CA). We retrospectively evaluated the outcomes of laparoscopic versus open appendectomies for CA.

Methods: Although laparoscopic appendectomies (LAs) are performed universally, a controversy still exists whether the LA is an appropriate surgical approach to complicated appendicitis (CA). We retrospectively evaluated the outcomes of laparoscopic versus open appendectomies for CA.

Results: There were no statistically significant differences in operative time between the LA and the open appendectomy (OA) groups. Return to soft diet was faster in the LA group (2.1 ± 1.2 vs. 3.5 ± 1.5 days; P = 0.001). Length of hospital stay was shorter for the LA group (4.4 ± 2.3 vs. 5.8 ± 2.9 days; P = 0.045). The overall complication rates showed no statistically significant difference between the two groups. In cases involving a periappendiceal abscess, the LA had a significantly higher incidence of intra-abdominal abscess (IAA) and postoperative ileus (PI; P = 0.028).

Conclusion: The LA showed good results in terms of the time to soft diet, the length of hospital stay, and surgical site infection (SSI) whereas the overall complication rates were similar for the two groups. However, the LA was associated with significantly higher incidence of IAA and PI for the cases with a periappendiceal abscess. Therefore, when using a LA, the surgeon must take great care to minimize the incidence of IAA and PI if a periappendiceal abscess is present.

키워드

Complicated appendicitis; Laparoscopic appendectomy; Open appendectomy
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