title: [Appendicectomy: laparoscopic versus open treatment. A case survey].
abstract: OBJECTIVE
  Laparoscopy is actually the gold standard approach in many surgical procedures: this consideration is still controversial as to appendectomy.
  
  
  METHODS
  From 2000 to 2004 we have performed 257 appendectomies: 51 (20%) in laparoscopic approach. Preoperative diagnosis has been formulated on blood parameters, abdominal or, sometimes, transvaginal ultrasonography.
  
  
  RESULTS
  Two hundred and fifty-seven surgical operations, 62 laparoscopic, have been performed for suspicious appendicitis. In the laparoscopic procedures, 11 revealed various diseases without appendicitis. In the remaining 51 cases, appendectomy has been performed totally intra-abdominal and none case turned to laparotomic conversion. Operative times were between 27 and 105 min in the laparoscopic appendectomies (LA) and between 18 and 46 min in the laparotomic appendectomies (OA). In 7.3% of OA and in 3.9% of LA wall infections occurred, as well as abdominal abscesses in 1% of OA and in 4% of LA. Postoperative discharge was after 3.3 days and bowel canalization appeared at 10-18 hours from the surgery, in OA and in LA.
  
  
  CONCLUSIONS
  On the basis of these results, the conclusion is drawn that, although discordant opinions in the literature, the advantages of the laparoscopic approach compared to laparotomic approach is still to be demonstrated, both in advantages for the patient and in costs. Laparoscopy is the better surgical technique when the preoperative diagnosis is not clear, particularly in young women or in elderly, in whom a colic neoplasm may be suspected.
authors.affiliation: U O Chirurgia Generale, Regione Toscana ASL 3 di Pistoia, P.O. SS. Cosma e Damiano, Viale Forti 102, 51017 Pescia (Pistoia), Italy.
authors.forename: I
authors.initials: I
authors.lastname: Corsale
authors.forename: E
authors.initials: E
authors.lastname: Buccianelli
authors.forename: S
authors.initials: S
authors.lastname: Sorce
authors.forename: F
authors.initials: F
authors.lastname: Aloise
authors.forename: M
authors.initials: M
authors.lastname: Bartolomei
authors.forename: P
authors.initials: P
authors.lastname: Mori
authors.forename: M
authors.initials: M
authors.lastname: Rigutini
authors.forename: A
authors.initials: A
authors.lastname: Veltroni
mesh_terms: D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D003625:Data Collection; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D012189:Retrospective Studies