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News

Traditional vs laparoscopic appendectomy in adults in English hospitals

The latest issue of Annals of Surgery compares traditional and laparoscopic appendectomy in adult outcomes in English NHS hospitals.

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Dr Omar Faiz and colleagues investigated length of stay, readmission rates, and postoperative mortality in adult patients undergoing traditional and laparoscopic appendectomy in England between 1996 and 2006.

The team included all procedures coded to the ‘H01-Emergency Excision of Appendix’ procedure code in the Hospital Episode Statistics database.

Multivariate analyses were used to identify independent predictors of length of hospital stay, 30-day and 365-day mortality.

The researchers found a total of 259,735 procedures were assigned to the H01-Emergency excision of appendix OPCS-4 3-digit code procedure between 1996 and 2006.

A laparoscopic technique was employed in 6%.

The research team found that a greater proportion of deaths occurred in hospital within 30 days of ‘open’ appendectomy surgery compared with procedures utilizing a laparoscopic technique.

The team found that 1-year mortality rates, measured over a 5-year period, were also higher after open surgery.

Multiple logistic regressions demonstrated that an open operative technique, older age, male gender, and increasing comorbidity were strong independent determinants of early and 1-year postoperative mortality after emergency appendectomy.

The researchers found that duration of stay for patients undergoing open emergency appendectomy exceeded that for patients undergoing the laparoscopic technique.

Patients undergoing a laparoscopic technique were, however, more likely to be readmitted within 28 days of surgery.

Dr Faiz’s team concluded, “Laparoscopic appendectomy is safe and associated with lower postoperative mortality rates than open procedures.”

“The cost implications are uncertain as this technique is associated with shorter hospital stay but higher subsequent readmission rates.”

 

 

 

 

Ann Surg 2008: 248(5): 800-6


31 October 2008

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