[Retrospective comparative study of 600 appendectomies carried out by laparotomy (Mac Burney) or laparoscopy. A plea for laparoscopy].
The authors report the results of a retrospective study comparing 305 appendectomies by laparotomy (performed in 1988-1989) with 295 appendectomies by laparoscopy (1990-1991). The appendectomy was performed by the "out" technic in 98% of cases of laparoscopy. The two populations are similar. There was no mortality. There was 1% of conversion, 1.4% of incidents and no major accident after laparoscopy. The post-operative course was smooth in 88.2% of cases after laparotomy and in 98% after laparoscopy. A treatment for pain was necessary in 98% of cases after laparotomy and only 45.4% after laparoscopy. The rates of parietal complications, intra-abdominal complications and reinterventions were respectively 10.8%, 1% and 2.4% after laparotomy and 0%, 2.4% and 2.4% after laparoscopy. The mean hospital stay was 7 days after laparotomy and 4 days after laparoscopy. In conclusion, laparoscopy appears superior to laparotomy for performance of an appendectomy: it allows better abdominal exploration, more simple and shorter post-operative course and suppresses parietal complications provided that it is performed by a surgeon with great experience of laparoscopy and respects classic principles of digestive surgery.
Balique
J G
JG
Service de Chirurgie générale, Hôpital Bellevue, C.H.R.U., bd Pasteur, Saint-Etienne.
Guinot
R
R
Mondesert
C
C
Mortier
L
L
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
Etude comparative rétrospective de 600 appendicectomies effectuées par laparotomie (Mac Burney) ou laparoscopie. Plaidoyer pour la laparoscopie.