title: Transition towards laparoscopic appendicectomy at a UK center over a 7-year period.
abstract: BACKGROUND
  Acute appendicitis remains the most common indication for emergency abdominal surgery in the United Kingdom. Although laparoscopic appendicectomy has demonstrable advantages over open appendicectomy, uptake has not been universal. The aims of this study were to describe trends in laparoscopic appendicectomy in a District General Hospital in Scotland.
  
  
  METHODS
  Retrospective review of appendix histopathology records within NHS Fife between 2003 and 2010. Note review of cases of acute appendicitis managed with laparoscopic appendicectomy was performed. Perioperative variables in perforated and nonperforated appendicitis were compared. A multivariate logistic regression analysis to determine factors associated with developing complications was performed.
  
  
  RESULTS
  Between 2003 and 2010, 237 laparoscopic appendicectomies were performed. The rate of laparoscopic appendicectomy increased from 2.5% in 2003 to 78% in 2010. In 50% of cases, the trainee surgeon was the primary operator. Complications occurred in 9.6% and the mortality rate was 0.4%. No factors on multivariate logistic regression predicted development of complications.
  
  
  CONCLUSIONS
  We describe a change in practice towards laparoscopic appendicectomy for the treatment of acute appendicitis over a 7-year period. Furthermore, laparoscopic appendicectomy is associated with acceptable morbidity rates.
authors.affiliation: Department of General Surgery, Victoria Hospital, Kirkaldy, Fife, UK.
authors.forename: Nicholas T
authors.initials: NT
authors.lastname: Ventham
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Dungworth
authors.forename: Carlo
authors.initials: C
authors.lastname: Benzoni
mesh_terms: D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006767:Hospitals, District; D006769:Hospitals, General; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland; D013997:Time Factors; D055815:Young Adult
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