A prospective, randomized, unicenter study comparing laparoscopic and open treatments of acute appendicitis

Abstract

Background: Appendectomy in the course of acute appendicitis is one of the most frequently performed surgical procedure in general surgery. The aim of this study was to compare the results of laparoscopic and conventional treatments for acute appendicitis in a prospective, randomized, unicenter study.

Methods: The study involved 200 patients treated for acute appendicitis in the Department of General and Vascular Surgery at Ceynowa Hospital in Wejherowo, Poland.

Results: The mean operative time for open surgery was 36.99 min. For laparoscopic method the operation was longer, requiring 47.75 min. Suction drainage was applied in 23 patients treated conventionally and 50 patients treated laparoscopically ( p < 0.05). The requirement for analgesia, measured by the number of metamizole ampules, was significantly higher in the conventional group. Pain on postoperative days 2 and 7 measured using a visual analog scale, was significantly more severe for the patients treated conventionally. The hospital stay in both groups did not differ significantly: 5.03 days for the conventional group and 4.71 days for the laparoscopic group. The time until return to work and social activities in the laparoscopic group (15.85 days) and was significantly shorter than in the conventional group (19.65 days). Seven complications occurred in the conventional group (6.7%) and nine (9.4%) in the laparoscopic group. The difference was not statistically significant. No deaths occurred.

Conclusions: On the basis of the conducted study, it may be assumed that laparoscopic appendectomy is a safe procedure, and that postoperative morbidity is comparable with that for a conventional operation. There was less postoperative pain and shorter recovery time after laparoscopic surgery than after the open procedure.