Laparoscopic versus open appendectomy: which way to go?
OBJECTIVE
To compare the outcome of laparoscopic versus open appendectomy.


METHODS
Prospectively collected data from 293 consecutive patients with acute appendicitis were studied. These comprised of 165 patients who underwent conventional appendectomy and 128 patients treated laparoscopically. The two groups were compared with respect to operative time, length of hospital stay, postoperative pain, complication rate and cost.


RESULTS
There were no statistical differences regarding patient characteristics between the two groups. Conversion to laparotomy was necessary in 2 patients (1.5%). Laparoscopic appendectomy was associated with a shorter hospital stay (2.2 d vs 3.1 d, P = 0.04), and lower incidence of wound infection (5.3% vs 12.8%, P = 0.03). However, in patients with complicated disease, intra-abdominal abscess formation was more common after laparoscopic appendectomy (5.3% vs 2.1%, P = 0.002). The operative time and analgesia requirements were similar in the two groups. The cost of treatment was higher by 370 EUR in the laparoscopic group.


CONCLUSIONS
Laparoscopic appendectomy is as safe and efficient as open appendectomy, provided surgical experience and equipment are available.
Kehagias
Ioannis
I
Department of Surgery, School of Medicine, University of Patras, Rion University Hospital, Patras, Greece. stkarama@yahoo.gr
Karamanakos
Stavros Nikolaos
SN
Panagiotopoulos
Spyros
S
Panagopoulos
Konstantinos
K
Kalfarentzos
Fotis
F