title: Laparoscopic versus conventional appendectomy.
abstract: BACKGROUND
  The results of recent series suggest remarkable advantages of laparoscopic appendectomy over the conventional open appendectomy. To determine if clear advantages could be established, the charts of all patients admitted to our institution with a presumptive diagnosis of acute appendicitis and subsequent appendectomy were retrospectively reviewed.
  
  
  METHODS
  From January 1990 through June 1992, there were 300 conventional open appendectomies and 66 laparoscopic appendectomies performed. Data from both groups were compared with respect to anesthesia time, operative time, postoperative morbidity, postoperative pain, time to regular diet, hospitalization period, cost, and return to normal activities.
  
  
  RESULTS
  There were no significant differences between the laparoscopic and open appendectomy groups with respect to operative complications, postoperative morbidity, pain medication requirements, and time to regular diet. There were significantly longer anesthesia times, operative times, and operating room costs in the laparoscopic group. For complicated appendicitis, the laparoscopic technique resulted in infectious complications that required readmission in 45.5 percent of the patients.
  
  
  CONCLUSIONS
  Laparoscopic appendectomy is a safe alternative to conventional open appendectomy for simple acute appendicitis. However, laparoscopic appendectomy is not superior to the conventional method with regard to operative time, postoperative morbidity, pain medication requirements, time to regular diet, length of stay, cost, or return to normal activity. Laparoscopic appendectomy may be contraindicated in complicated appendicitis (gangrene, perforated with abscess, or peritonitis) due to an increased rate of infectious complications requiring readmission.
authors.affiliation: Department of Surgery, Lehigh Valley Hospital, Allentown, Pennsylvania 18103.
authors.forename: F
authors.initials: F
authors.lastname: Bonanni
authors.forename: J
authors.initials: J
authors.lastname: Reed
authors.forename: G
authors.initials: G
authors.lastname: Hartzell
authors.forename: D
authors.initials: D
authors.lastname: Trostle
authors.forename: R
authors.initials: R
authors.lastname: Boorse
authors.forename: M
authors.initials: M
authors.lastname: Gittleman
authors.forename: A
authors.initials: A
authors.lastname: Cole
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies