title: Laparoscopic versus open surgery for complicated appendicitis: a randomized controlled trial to prove safety.
abstract: BACKGROUND
  To date, no randomized control trial has been performed comparing open appendectomy (OA) to laparoscopic appendectomy (LA) in complicated appendicitis. A systematic review and meta-analysis in 2010 concluded LA is advantageous to OA with less surgical site sepsis in complicated appendicitis; however, the level of evidence is weak (level 3a). The aim of the study was to determine whether LA is safe in the treatment of complicated appendicitis. Primary outcome included all-cause mortality and procedure-related mortality; secondary outcomes included intra-operative duration, rates of wound sepsis and re-intervention, length of hospital stay and re-admission rates.
  
  
  METHODS
  One hundred and fourteen patients were randomized prospectively to either OA or LA using a computer-generated blind method. Patients who were either less than 12 years of age, had previous abdominal surgery or were pregnant were excluded. A team of senior surgeons capable of doing both OA and LA performed all procedures.
  
  
  RESULTS
  The intra-operative duration, the rate of wound sepsis, the number of re-operations, the length of hospital stay and the rate of re-admissions between the OA and LA groups did not differ statistically.
  
  
  CONCLUSIONS
  Laparoscopic appendectomy is safe in complicated appendicitis. Current Control Trials (ISRCTN92257749).
authors.affiliation: Department of Surgery, Chris Hani Baragwanath Academic Hospital, Old Potch Road, Moreleta Park, Soweto, Johannesburg, 2013, South Africa, drjohnthomson@gmail.com.
authors.forename: John-Edwin
authors.initials: JE
authors.lastname: Thomson
authors.forename: Deirdré
authors.initials: D
authors.lastname: Kruger
authors.forename: Christine
authors.initials: C
authors.lastname: Jann-Kruger
authors.forename: Akos
authors.initials: A
authors.lastname: Kiss
authors.forename: J A O
authors.initials: JA
authors.lastname: Omoshoro-Jones
authors.forename: Thifheli
authors.initials: T
authors.lastname: Luvhengo
authors.forename: Martin
authors.initials: M
authors.lastname: Brand
mesh_terms: D000293:Adolescent; D000328:Adult; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007813:Laparotomy / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D061646:Operative Time; D010359:Patient Readmission / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology*; D012086:Reoperation; D018805:Sepsis / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult