Laparoscopic versus open appendectomy in men: a prospective randomized trial.
BACKGROUND
The role of laparoscopic treatment in acute appendicitis still is unclear. Although some evidence in the literature suggests diagnostic benefits from laparoscopy for young women with suspected acute appendicitis, there is scepticism about the utility of this approach for men. This study aimed to compare open and laparoscopic appendectomy performed for men with suspected acute appendicitis.


METHODS
All male patients older than 15 years with an American Society of Anesthesiology (ASA) classification of 3 or less, no previous abdominal surgery, and no contraindication for pneumoperitoneum were prospectively randomized to undergo either open appendectomy (OA) or laparoscopic appendectomy (LA). The primary end point was a detected difference in postoperative hospital length of stay, and the secondary end points were detected differences in postoperative analgesia, morbidity, and length of the recovery period.


RESULTS
In this study, 147 men with suspected acute appendicitis were randomized to either OA (n = 75) or LA (n = 72). It took longer to perform LA (60 min; range, 20-120 min vs. 45 min; range, 20-90 min; p = 0.0027), and LA did not result in any significant difference for the parameters evaluated.


CONCLUSIONS
The postoperative length of hospital stay did not differ significantly between OA and LA for men. Laparoscopic appendectomy required more time and did not offer any advantages compared with OA.
Tzovaras
George
G
Department of Surgery, University Hospital of Larissa, 411 10, Larissa, Greece. gtzovaras@hotmail.com
Baloyiannis
Ioannis
I
Kouritas
Vassilios
V
Symeonidis
Dimitris
D
Spyridakis
Michael
M
Poultsidi
Antigoni
A
Tepetes
Konstantinos
K
Zacharoulis
Dimitris
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult