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Clinical Trial
. 1998 Apr-Jun;2(2):153-8.

A comparison of laparoscopic and open appendectomy

M Tarnoff  1 , U Atabek, M Goodman, J B Alexander, F Chrzanowski, K Mortman, R Camishon, M Pello
Affiliations
Clinical Trial

A comparison of laparoscopic and open appendectomy

M Tarnoff et al. JSLS. 1998 Apr-Jun.

Abstract

Background and objectives: To compare laparoscopic appendectomy with traditional open appendectomy.

Methods: Seventy-one patients requiring operative intervention for suspected acute appendicitis were prospectively compared. Thirty-seven patients underwent laparoscopic appendectomy, and 34 had open appendectomy through a right lower quadrant incision. Length of surgery, postoperative morbidity and length of postoperative stay (LOS) were recorded. Both groups were similar with regard to age, gender, height, weight, fever, leukocytosis, and incidence of normal vs. gangrenous or perforated appendix.

Results: Mean LOS was significantly shorter for patients with acute suppurative appendicitis who underwent laparoscopic appendectomy (2.5 days vs. 4.0 days, p < 0.01). Mean LOS was no different when patients classified as having gangrenous or perforated appendicitis were included in the analysis (3.7 days vs. 4.1 days, P = 0.11). The laparoscopy group had significantly longer surgery times (72 min vs. 58 min, p < 0.001). There was no significant difference in the incidence of postoperative morbidity.

Conclusions: Laparoscopic appendectomy reduces LOS as compared with the traditional open technique in patients with acute suppurative appendicitis. The longer operative time for the laparoscopic approach in our study is likely related to the learning curve associated with the procedure and did not increase morbidity.

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Figures

Figure 1.
Figure 1.
Incidence of various postoperative complications and total complications in the laparoscopic and open appendectomy groups.
Figure 2.
Figure 2.
Postoperative length of stay in the laparoscopic versus open appendectomy groups for both acute suppurative (non-perforated, non-gangrenous) appendicitis and perforated and/or gangrenous appendicitis. The length of stay was significantly shorter for the laparoscopic appendectomy group as compared to the open appendectomy group when the appendix was not perforated or gangrenous (*P < 0.01); however, in the presence of a perforated or gangrenous appendix, there was no significant difference (P = 0.11).
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