title: [Acute appendicitis - clinical health-service research on the current surgical therapy].
abstract: BACKGROUND
  With about 135,000 operations every year appendectomy is one of the most frequent surgical operations in Germany. Acute appendicitis has shown changes in diagnosis and therapy with time. The status of the laparoscopic appendectomy has had to be redefined recently. The aim of this study was to make an analysis of the current surgical therapy for appendicitis and the individual procedures.
  
  
  METHODS
  Three prospective multi-centre quality assurance studies (1988 / 89, 1996 / 97; 2008 / 09) of the "An-Institut" acquired 17,732 treatments from all supply levels of Germany.
  
  
  RESULTS
  The average age of patients increased within of the three studies from 25.7 to 34.6 years. Within the studies in 1996 / 97 and in 2008 / 09 the share of laparoscopic appendectomy advanced from 33.1 to 85.8 percent. In the study from 2008 / 09 the laparoscopic appendectomy showed a significant advantage over the conventional technique in terms of wound-healing disturbances (p < 0.001) and a clinical duration of stay (p < 0.001). At no stage of the appendix inflammation did the laparoscopic appendectomy lead to a significant increase of intraabdominal abscesses. Compared with the conventional technique the operating time was shorter (46.6 min vs. 53.5 min). Currently the use of a stapler is the mostly frequently applied method of appendiceal stump closure (83.6 percent).
  
  
  CONCLUSIONS
  The laparoscopic appendectomy is the most common method of current operative therapy. In comparison to former publications, there is no proof of any disadvantages of laparoscopic appendectomy.
authors.affiliation: DRK Kliniken Berlin / Köpenick, Klinik für Chirurgie, Berlin, Deutschland. m.sahm@drk-kliniken-berlin.de
authors.forename: M
authors.initials: M
authors.lastname: Sahm
authors.forename: A
authors.initials: A
authors.lastname: Koch
authors.forename: U
authors.initials: U
authors.lastname: Schmidt
authors.forename: S
authors.initials: S
authors.lastname: Wolff
authors.forename: M
authors.initials: M
authors.lastname: Pross
authors.forename: I
authors.initials: I
authors.lastname: Gastinger
authors.forename: H
authors.initials: H
authors.lastname: Lippert
mesh_terms: D000328:Adult; D000367:Age Factors; D001062:Appendectomy / Q000706:statistics & numerical data; D001064:Appendicitis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006302:Health Services Research; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care; D012737:Sex Factors; D017792:Surgical Stapling / Q000706:statistics & numerical data; D014463:Ultrasonography / Q000706:statistics & numerical data; D014945:Wound Healing