title: Randomized clinical trial of laparoscopic versus open appendicectomy.
abstract: BACKGROUND
  Laparoscopy in patients with a clinical suspicion of acute appendicitis has not gained wide acceptance, and its use remains controversial.
  
  
  METHODS
  In a randomized controlled trial of laparoscopic versus open appendicectomy, 583 of 828 consecutive patients consented to participate. Three hundred and one patients were allocated to open appendicectomy and 282 patients to laparoscopy, 65 of whom required conversion to open appendicectomy. Length of stay in hospital was the primary endpoint, while operating time, postoperative morbidity, duration of convalescence and cosmesis were secondary endpoints.
  
  
  RESULTS
  Intention-to-treat analysis revealed an equally short hospital stay in the two groups (median 2 days). The median time to return to normal activity (7 versus 10 days) and work (10 versus 16 days) was significantly shorter following laparoscopy. Laparoscopy was associated with fewer wound infections (P < 0.03) and improved cosmesis (P < 0.001), but the operating time was longer (60 versus 40 min). Laparoscopy was associated with more intraperitoneal abscesses (5 versus 1 per cent) but, adjusted for a greater number of gangrenous or perforated appendices in this group, the difference failed to reach statistical significance.
  
  
  CONCLUSIONS
  Hospital stay was equally short, whereas laparoscopic appendicectomy was associated with fewer wound infections, faster recovery, earlier return to work and improved cosmesis.
authors.affiliation: Department of Surgery, Aarhus University Hospital, Aarhus, Denmark. agorm@dadlnet.dk
authors.forename: A G
authors.initials: AG
authors.lastname: Pedersen
authors.forename: O B
authors.initials: OB
authors.lastname: Petersen
authors.forename: P
authors.initials: P
authors.lastname: Wara
authors.forename: H
authors.initials: H
authors.lastname: Rønning
authors.forename: N
authors.initials: N
authors.lastname: Qvist
authors.forename: S
authors.initials: S
authors.lastname: Laurberg
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome