title: Short- and long-term results of open versus laparoscopic appendectomy.
abstract: BACKGROUND
  Clinical advantages of laparoscopic appendectomy have been shown in numerous trials and reviews. Most of these advantages are small and of limited clinical relevance, while laparoscopic operation costs are reported to be higher. The present study compares short- and long-term results of conventional appendectomy with or without diagnostic laparoscopy (OA), and laparoscopic appendectomy (LA).
  
  
  METHODS
  All adult patients who underwent appendectomy in our institution from 1995 to 2005 were included retrospectively. Patient data were retrieved from medical records, questionnaires sent by mail, and records of general practitioners. Primary outcome parameters were long-term complications, readmissions, and reinterventions (>30 days postoperatively). Secondary outcome parameters were short-term complications, readmissions, and reinterventions (≤30 days postoperatively).
  
  
  RESULTS
  A total of 755 patients were included, 545 of whom underwent OA, with the remaining 210 undergoing LA. In the long term there were few complications noted, and there were no significant differences in complications between the two groups. Within 30 days postoperatively, LA was associated with a significantly higher incidence of abdominal abscesses with consequent diagnostic investigations, interventions, and readmissions.
  
  
  CONCLUSIONS
  Although laparoscopic appendectomy is known to deliver clinical advantages, it is associated with a higher incidence of abdominal abscesses. Because the procedure is about to become the standard of care, future research must be directed at solving this issue. The expected lower incidence of incisional hernia and small bowel obstruction after laparoscopic appendectomy was not shown in the present study.
authors.affiliation: Department of Surgery, Academic Medical Centre, University of Amsterdam, 22660, 1100 DD, Amsterdam, The Netherlands.
authors.forename: H A
authors.initials: HA
authors.lastname: Swank
authors.forename: E J
authors.initials: EJ
authors.lastname: Eshuis
authors.forename: M I
authors.initials: MI
authors.lastname: van Berge Henegouwen
authors.forename: W A
authors.initials: WA
authors.lastname: Bemelman
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods*; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay / Q000639:trends; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013997:Time Factors; D055815:Young Adult