title: Laparoscopic appendicectomy is associated with a lower complication rate even during the introductory phase.
abstract: BACKGROUND
  The benefit of laparoscopic appendicectomy is under debate. To study the beneficial clinical effects of laparoscopic appendicectomy during the introductory phase we analysed, retrospectively, 493 patients from one district general hospital.
  
  
  METHODS
  During a period of 3 years 250 patients were operated on prospectively by open appendicectomy, and 243 patients were operated on laparoscopically. Both groups were compared with regard to their demographic data, operation time, body mass index and complication rate.
  
  
  RESULTS
  The conversion rate was 4.5%. The distribution of histological stages of inflammation was comparable in both groups. The median operating time was significantly longer for the open (40 min) than for the laparoscopic procedure (35 min, P=0.002). The body mass index in the laparoscopic group was significant higher (23.7 kg/m(2) vs 22.6 kg/m(2), P=0.009). Perioperative white blood cell count, C-reactive protein and body temperature were equal in both groups. There was no significant difference with regard to the analgesia required postoperatively between the open and the laparoscopic group. Nevertheless, the specific complication rate after open appendicectomy (18.4%) was significantly higher than that following laparoscopic appendicectomy (10.8%, P=0.03).
  
  
  CONCLUSIONS
  Even during the introductory phase, laparoscopic appendicectomy is a safe and clinically beneficial operating procedure.
authors.affiliation: Clinic of General Surgery, Friedrich Ebert Krankenhaus, Neumuenster, Germany. mkapischke@web.de
authors.forename: Matthias
authors.initials: M
authors.lastname: Kapischke
authors.forename: Juergen
authors.initials: J
authors.lastname: Tepel
authors.forename: Klaus
authors.initials: K
authors.lastname: Bley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000009:adverse effects* / Q000379:methods*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies