title: Laparoscopic versus open appendectomy for the treatment of complicated appendicitis.
abstract: OBJECTIVE
  Laparoscopic Appendectomy (LA) is widely performed for the treatment of acute appendicitis. However the use of laparoscopic approach for complicated appendicitis is controversial, in particular because it has been reported an increased risk of postoperative IntraAbdominal Abscess (IAA). The aim of this study was to compare the outcomes of LA versus Open Appendectomy (OA) in the treatment of complicated appendicitis, especially with regard to the incidence of postoperative IAA.
  
  
  METHODS
  A retrospective study of all patients treated at our institution for complicated appendicitis, from May 2004 to June 2009, was performed. Data collection included demographic characteristics, postoperative complications, conversion rate, and length of hospital stay.
  
  
  RESULTS
  Thirty-eight patients with complicated appendicitis were analysed. Among these, 18 (47,3%) had LA and 20 (52,7%) had OA. There were no statistical differences in characteristics between the two groups. The incidence of postoperative IAA was higher (16,6%), although not statistically significant, in the LA compared with OA group (5%). On the other hand the rate of wound infection was lower (5%) in the LA versus OA (20%).
  
  
  CONCLUSIONS
  Our study indicated that LA should be utilised with caution in case of perforated appendicitis, because it is associated with an increased risk of postoperative IAA compared with OA.
authors.affiliation: Department of General and Mini-invasive Surgery, San Paolo Hospital, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ferranti
authors.forename: F
authors.initials: F
authors.lastname: Corona
authors.forename: L M
authors.initials: LM
authors.lastname: Siani
authors.forename: A
authors.initials: A
authors.lastname: Stefanuto
authors.forename: D
authors.initials: D
authors.lastname: Aguzzi
authors.forename: E
authors.initials: E
authors.lastname: Santoro
mesh_terms: D000293:Adolescent; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult