Experience with laparoscopic and open appendectomies in a surgical residency program.
Laparoscopic appendectomy represents another challenge for residency training. This retrospective study was conducted to determine the efficacy of this operation, to contrast it to conventional appendectomy, and to describe experience in teaching residents. We examined the case records of 151 patients who underwent appendectomies performed by residents between September 1990 and September 1992. Surgery was performed laparoscopically in 26% of the cases, by conventional means in 65%, and converted to an open procedure in 9% of the total patients. Acute appendicitis was confirmed in 56% of laparoscopic patients, 85% of conventional patients, and 86% of converted patients. Age, sex, signs and symptoms, complications, and operative times were similar in laparoscopic and conventional groups. Mean hospital stay was 3.5 days in the laparoscopic group, 4.5 days in the conventional group, and 8.5 days in the converted group. Operating room charges were highest in the laparoscopic group. Surgical procedure depended on the experience and bias of the attending surgeon. Laparoscopic appendectomy appears to be easily learned by surgical residents and to be associated with an outcome similar to that of conventional appendectomy.
Department of Surgical Education, Memorial Medical Center, Savannah, GA 31403-3089.
G E
GE
Neal
E C
EC
McClintic
J S
JS
Williams
D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D001062:Appendectomy / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data; D001064:Appendicitis / Q000191:economics / Q000453:epidemiology / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D017678:Sex Distribution; D013997:Time Factors