[Laparoscopic or open appendectomy. A randomised prospective study.].
BACKGROUND
Operative mortality after open appendectomy is negligible, hospital stay is short and complications mostly wound infections infrequent. Laparoscopic appendectomy has not been considered the operation of choice because the potential savings in hospital costs would be small. However studies have shown laparoscopic appendectomy to be a safe and technically easy operation. Postoperative pain is generally less and hospital stay shorter after laparoscopic than after open operations. Time off work should also decrease. The aim of this study was to compare in a prospective randomised study, complications, operative time, length of hospital stay and time off work after conventional open and laparoscopic appendectomy.


METHODS
Forty consecutive patients (5=15 years of age) diagnosed clinically with acute appendicitis during a 15 week period, were randomised to either laparoscopic (n=20) or open (n=20) appendectomy. Complications, operative time, length of hospital stay and time off work after operation were the main outcome measures.


RESULTS
Complications were infrequent in both groups and operative time was longer in the laparoscopic group (75 min vs. 45 min, p<0.001). Patients in the laparoscopic group returned to work seven days (median) after the operation but 10 days after an open operation (p<0.05). Hospital stay was two days for the laparoscopic group and three days for the open group (ns).


CONCLUSIONS
Laparoscopic appendectomy is a save procedure. Patients return to work earlier than after conventional operation. We consider laparoscopic appendectomy to be the operation of choice for appendicitis.
Gudbjartsson
T
T
Smith
A
A
Kristvinsson
H
H
Jonsson
T
T
Magnusson
J
J