Laparoscopic appendectomy is widely performed in many countries.
However, laparoscopic appendectomy for complicated appendicitis, which includes perforated or gangrenous appendicitis with or without localized or disseminated peritonitis, has not become a common practice yet.
Dr Goutaro Katsuno and colleagues from Japan retrospectively analyzed the clinical records of 230 patients who had undergone appendectomy for complicated appendicitis.
The team reported that 141 had undergone laparoscopic appendectomy, 84 had conventional open appendectomy, and 5 patients had conversion to the open procedure after laparoscopy.
|The complication rate was 13% with total laparoscopic appendectomy|
|World Journal of Surgery|
The laparoscopic group was subdivided into ‘early experience’, and ‘late experience’.
The research team defined the early laparoscopic group as the comparison group to minimize selection bias.
Patient demographics were similar in the early laparoscopic and open appendectomy.
Wound infection was significantly more frequent in the open appendectomy group.
Intra-abdominal infection was equally common in these two groups.
The overall rate of postoperative complications was significantly higher in the open appendectomy group than in the early laparoscopic group.
The research team observed that this incidence was 13% in the total laparoscopic appendectomy group.
The team noted that hospital stay was significantly shorter in the early laparoscopic group, and 9 days in the total laparoscopic appendectomy group.
Dr Katsuno’s team concludes, “Our findings indicate that laparoscopic appendectomy is safe and useful even for the treatment of complicated appendicitis if performed by an experienced surgeon.”