[Laparoscopic appendectomy. Present situation. ABC medical center experience during the last five years].
OBJECTIVE
To compare the diagnostic and therapeutic accuracy of laparoscopic appendectomy versus open appendectomy.


BACKGROUND
Appendectomy is the treatment of choice for acute appendicitis. Open Appendectomy (OA) has its complications rates (10-20%) and negative explorations in young women are about 25-30%. Acute appendicitis has a 3.1% morbidity and with perforation up to 47.2% and a mortality rate less than 1%. Advantages of laparoscopic appendectomy (LA) has been shown in many studies with lower intraoperatory and postoperatory complications, less hospitalization days, lower pain and faster return to daily activities when its compared with OA.


METHODS
We perform a retrospective and descriptive trial with 1,883 patients with acute appendicitis between January 2000 to September 2004. Patients smaller than 15 years old and with other postoperatory diagnosis were excluded. Ji2 and t Student statistic tests were performed.


RESULTS
We obtained 1,272 patients with acute appendicitis, 49% male and 51% female. LA was performed in 732 patients, 46.1% male and 53.9% female and OA was performed in 541 patients, 52.6% male and 47.3% female. Similar midage patients in both groups. LS was performed in 180 patients with complicated appendicitis and 116 patients by OA. LA was converted to open surgery in 4.5% patients. Morbidity was lower for laparoscopic group with statistical difference. There were no difference in fasting and hospitalization days.


CONCLUSIONS
This procedure is a good choice for differential diagnosis overall in young women and complicated appendicitis with lower morbidity than the OA.
Spaventa Ibarrola
Antonio
A
Departamento de Cirugía Endoscópica, The American British Cowdray Medical Center I. A. P México, DF. a_spaventa@hotmail.com
Decanini Terán
César
C
Becerril Martínez
Guillermo
G
González Lazzeri
Sergio
S
Menéndez Skertchly
Ana
A
Gaertner Wolff
Wolfgang
W
Arias Gutiérrez
Alfonso
A
Hernández Vera
Francisco
F
Arriola Sánchez
Jorge
J
Golffier Rosete
Claudio
C
D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome