Morbidity of laparoscopic surgery for complicated appendicitis: an international study.
BACKGROUND
Although laparoscopic appendectomy has some advantages over open appendectomy, some reports do show more postoperative intraabdominal abscesses.


METHODS
A retrospective review of complicated appendicitis managed surgically by eight surgical groups from six countries was undertaken. Among 3,433 patients with appendicitis, 1,017 (29.5%) had complicated appendicitis, which included perforated or gangrenous appendicitis with or without localized or disseminated peritonitis. There were 74 preoperative abscesses (7.4%) and 5 small bowel obstructions.


RESULTS
One patient died. There were 29 postoperative intraabdominal abscesses (2.8%) and 112 mostly minor complications. Conversion to laparotomy was necessary for 28 patients (2.7%). The surgical time ranged from 32 to 132 min (mean, 62 min), and the hospital stay ranged from 1 to 18 days (mean, 3.5 days).


CONCLUSIONS
The morbidity rates, particularly for intraabdominal abscesses, were less for laparoscopic appendectomy in complicated appendicitis than those reported in the literature for open appendectomy, whereas operating times and hospital stays were similar.
Department of Surgery, Hospitals ABC y Angeles Lomas, Mexico City, Mexico. cuetoj@prodigy.net.mx
J
J
Cueto
B
B
D'Allemagne
J A
JA
Vázquez-Frias
S
S
Gomez
F
F
Delgado
L
L
Trullenque
R
R
Fajardo
S
S
Valencia
L
L
Poggi
J
J
Ballí
J
J
Diaz
R
R
González
J H
JH
Mansur
M E
ME
Franklin
D018784:Abdominal Abscess / Q000453:epidemiology / Q000209:etiology; D000369:Aged, 80 and over; D001062:Appendectomy / Q000009:adverse effects* / Q000379:methods*; D001064:Appendicitis / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D038622:Internationality; D007415:Intestinal Obstruction / Q000150:complications; D010535:Laparoscopy / Q000009:adverse effects*; D007813:Laparotomy; D007902:Length of Stay; D010538:Peritonitis / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors