Meta-analysis of the results of randomized controlled trials that compared laparoscopic and open surgery for acute appendicitis.
OBJECTIVE
We conducted a meta-analysis to evaluate and compare the outcomes of laparoscopic and open surgery for the treatment of patients with acute appendicitis.


METHODS
We searched MEDLINE, EMBASE, Science Citation Index, and the Cochrane Controlled Trial Register for relevant papers published between January 1990 and February 2012. We analyzed 22 outcomes of laparoscopic and open surgery for acute appendicitis.


RESULTS
We identified 39 papers reporting results from randomized controlled trials that compared laparoscopic surgery with open surgery for acute appendicitis. Our meta-analysis included 5,896 patients with acute appendicitis; 2,847 had undergone laparoscopic surgery, and 3,049 had undergone open surgery. Compared with open surgery, laparoscopic surgery was associated with longer operative time (by 13.12 min). However, compared with open surgery, laparoscopic surgery for acute appendicitis was associated with earlier resumption of liquid and solid intake; shorter duration of postoperative hospital stay; a reduction in dose numbers of parenteral and oral analgesics; earlier return to normal activity, work, and normal life; decreased occurrence of wound infection; a better cosmesis; and similar hospital charges.


CONCLUSIONS
Laparoscopic surgery may now be the standard treatment for acute appendicitis.
Department of Surgery, Osaka City Sumiyoshi Hospital, 1-2-16, Higashi-Kagaya, Suminoe-ku, Osaka, 559-0012, Japan. m5051923@msic.med.osaka-cu.ac.jp
Hiroshi
H
Ohtani
Yutaka
Y
Tamamori
Yuichi
Y
Arimoto
Yukio
Y
Nishiguchi
Kiyoshi
K
Maeda
Kosei
K
Hirakawa
D000208:Acute Disease; D001062:Appendectomy / Q000191:economics / Q000379:methods* / Q000534:rehabilitation; D001064:Appendicitis / Q000191:economics / Q000601:surgery*; D002921:Cicatrix / Q000209:etiology; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000534:rehabilitation; D007902:Length of Stay / Q000706:statistics & numerical data; D061646:Operative Time; D011183:Postoperative Complications; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D016896:Treatment Outcome