Comparison of laparoscopic-assisted appendectomy with intracorporal laparoscopic appendectomy and open appendectomy.
BACKGROUND
A laparoscopic appendectomy is associated with less postoperative pain and a shorter postoperative stay than the open technique. However, the open technique is faster and less expensive than the completely laparoscopic method. A laparoscopic-assisted appendectomy has the advantages of both the laparoscopic and open techniques.


METHODS
A retrospective study involving 83 patients was performed comparing the three different techniques. The comparison studied operating time, surgical expense, and postoperative stay.


RESULTS
The completely laparoscopic method was performed on 24 patients with an average surgical time of 88.9 minutes, average charges of $604, and average postoperative stay of 2.6 days. The open technique was performed on 26 patients with a surgical time of 77.1 minutes, charges of $42, and a postoperative stay of 2.4 days. The laparoscopic-assisted technique was performed on 33 patients with a surgical time of 70.3 minutes, charges of $208, and a postoperative stay of 1.8 days.


CONCLUSIONS
The laparoscopic-assisted method of appendix removal can be performed as efficiently as the open technique but at <67% of the cost of the complete laparoscopic method. The postoperative stay is shorter for the laparoscopic-assisted technique than for the open technique. Thus, the laparoscopic-assisted technique is a cost-effective method for removing the appendix.
Nicholson
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Department of General Surgery, York Hospital, York, PA 17405, USA.
Tiruchelvam
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D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery; D016009:Chi-Square Distribution; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D053685:Laser Therapy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011336:Probability; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors