[Open vs. laparoscopic appendectomy].
This article discusses the question of whether open or laparoscopic appendectomy is preferable in today's clinical routine. The article is based on data from randomized studies, evaluation of meta-analyses, and data from nonrandomized, multicentric studies evaluating the treatment of appendicitis in routine clinical practice. According to the data analysis, open appendectomy (OA) offers advantages with regard to a significantly shorter operative time and lower hospital costs. Laparoscopic appendectomy (LA) is characterized by a significantly decreased rate of failed septic wound healing and faster recovery. Both procedures can be performed with the same degree of safety and comparable outcome for acute appendicitis. Laparoscopic appendectomy offers significant advantages for establishing a precise diagnosis in young fertile women and overweight patients suffering from lower abdominal pain. The currently available data do not provide precise guidelines for the treatment of perforating appendicitis. However, we found significant evidence indicating an increased rate of postoperative intra-abdominal abscess after laparoscopic appendectomy. Thus, a laparoscopic approach cannot be regarded as a standard technique in advanced appendicitis.
Lippert
H
H
Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Otto-von-Guericke-Universität Magdeburg, Leipziger Strasse 44, 39120 Magdeburg. AKChirurg@aol.com
Koch
A
A
Marusch
F
F
Wolff
S
S
Gastinger
I
I
D018784:Abdominal Abscess / Q000209:etiology; D000208:Acute Disease; D000328:Adult; D001062:Appendectomy / Q000191:economics / Q000379:methods*; D001064:Appendicitis / Q000150:complications / Q000601:surgery*; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics; D008297:Male; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors