Therapeutic effectiveness and influencing factors of laparoscopic appendectomy with mesoappendix dissection in the treatment of acute appendicitis

Abstract

Background: Acute appendicitis (AP) is a frequently encountered surgical emergency, and appendectomy is conventionally regarded as the predominant treatment modality. Nevertheless, the therapeutic efficacy of this surgical approach remains to be improved. Thus, the exploration and implementation of surgical refinements are necessary.

Aim: To elucidate the therapeutic effectiveness and influencing factors of laparoscopic appendectomy (LA) with mesoappendix dissection in the treatment of AP.

Methods: First, 150 patients with AP who visited Shangrao Municipal Hospital between January 2022 and June 2024 were enrolled in this study. Among them, 72 patients were assigned to the control group to receive conventional LA, whereas 78 cases were included in the observation group for LA with mesoappendix dissection. Subsequently, indicators such as therapeutic effectiveness, surgical indices (operation time, intraoperative blood loss, and hospital stay), postoperative recovery indices (time to ambulation, gastrointestinal function recovery time, and time to food intake), incidence of adverse events (postoperative bleeding, pelvic infection, puncture site infection, and ileus), and serum inflammatory factors [tumor necrosis factor (TNF)-α, interleukin (IL)-6, and C-reactive protein (CRP)] were collected and comparatively analyzed, and the influencing factors of therapeutic effectiveness in patients with AP were analyzed.

Results: Compared with the control group, the observation group had higher clinical therapeutic effectiveness, less operation time, intraoperative blood loss, and hospital stay; shorter time to ambulation, gastrointestinal function recovery, and food intake; and a lower total incidence of adverse events, and this difference is statistically significant. In addition, the expression levels of various serum inflammatory factors in the observation group were significantly reduced postoperatively, which were markedly lower than those in the control group. Moreover, sex, age, body mass index, time from acute onset to admission, family medical history, preoperative TNF-α, preoperative IL-6, preoperative CRP, and treatment modality were identified to be not independent factors affecting the therapeutic effectiveness of LA with mesoappendix dissection in patients with AP.

Conclusion: Overall, LA with mesoappendix dissection has a remarkable curative effect in treating patients with AP, which is worthy of clinical promotion.

Keywords: Acute appendicitis; Analysis of influencing factors; Appendectomy with mesoappendix dissection; Laparoscopy; Therapeutic effectiveness.

Figure 1

Serum inflammatory factors in two groups. A: Pre- and post-operative tumor necrosis factor-α levels in the two groups; B: Pre- and post-operative interleukin-6 levels in the two groups; C: Pre- and post-operative C-reactive protein levels in the two groups. ^aP < 0.05 and ^bP < 0.01 compared with the preoperative level within the group; ^cP < 0.05 compared with the control group; TNF-α: Tumor necrosis factor-α; IL-6: Interleukin-6; CRP: C-reactive protein.