The role of laparoscopy in the management of patients with suspected acute appendicitis remains controversial.
It has been suggested that laparoscopy is useful mainly in young women of reproductive age because of the high incidence of wrong diagnosis in these patients.
Dr George Tzovaras and colleagues from Greece prospectively used different management protocols for patients with suspected acute appendicitis in male and female patients.
Women of reproductive age were treated laparoscopically, while men were randomized to open or laparoscopic appendectomy.
The researchers treated 132 patients with suspected acute appendicitis according to the protocol between 2002 and 2005.
|The incidence of wrong diagnosis occurred in 26% of females|
|World Journal of Surgery|
Of the patients, 54 were women and 78 men.
The incidence of wrong diagnosis in female patients was high, occurring in 26%, and a low conversion rate of 6%.
In contrast, the team observed in the laparoscopic male subgroup that these rates showed a reverse relationship.
The researchers noted that morbidity did not differ between female and male patients or between the 2 arms of the male group.
Laparoscopic appendectomy took longer to perform without affecting significantly the needs for postoperative analgesia.
The research team found that the duration of hospital stay, and the time to return to normal activities when compared with open appendectomy in men.
Dr George Tzovaras team concluded, “Laparoscopic appendectomy is at least as safe as the open procedure in the male population, although it does not appear to offer any obvious advantage over the open procedure.”
“The diagnostic advantage that laparoscopy offers to fertile women makes the procedure attractive for this population.”