Comparative study of laparoscopic appendectomy for complicated and uncomplicated acute appendicitis

Abstract

Abstract: AIM: To investigate the effect of laparoscopic appendectomy in both complicated and uncomplicated cases of acute appendicitis.METHODS: A retrospective, observational study design was used to analyze several outcomes using the data of all laparoscopic appendectomy procedures from January 2011 to February 2013 in patients with complicated or uncomplicated appendicitis. Data on several surgical outcome measures were collected.RESULTS: A total of 149 laparoscopic appendectomy procedures performed. 133 patients with complicated or uncomplicated acute appendicitis were included in the study. There was no mortality in both CAA group with 48 cases and UCAA group with 85 cases. Preoperatively, in patients with CAA, duration of symptoms, incidence rate of diffuse peritonitis, blood leukocyte count, neutrophil percentage were significantly higher than in patients with UCAA (all P<0.05).Intraoperatively, in patients with CAA, quantity of pus, peritoneal irrigation rate, peritoneal drainage rate and operation time were significantly higher than in patients with UCAA (all P<0.05). Conversion to open surgery was necessary in 4 patients in CAA group and in 2 patients in UCAA group. Conversion rate had no significant difference between two groups (8.3% for CAA vs 2.4% for UCAA, P>0.05).Postoperatively, two groups of ambulation time, restoration of anal exhaust, incidence rate of Trocar hole infection, incidence rate of intra-abdominal abscess, incidence rate of bowel obstruction had no significant difference (P>0.05). In the two groups, the difference between the length of hospital stay and hospital costs also had no statistical significance (P>0.05).CONCLUSION: Laparoscopic appendectomy for complicated acute appendicitis is comparable to uncomplicated acute appendicitis in terms of several surgical outcomes, although the inflammatory response in patients with complicated acute appendicitis is more serious than uncomlicated acute appendicitis. Therefore, laparoscopic technique may be a feasible, safe, and efficacious method in the therapy of complicated acute appendicitis.

Key words: Laparoscope, Appendicitis, Appendectomy

CLC Number:

R656.8

WANG Ming-hai, ZHAO Guo-hai, SHI Liang-hui, CHEN Fang-zheng, XIA Ya-bin, XU Ran, WU Ze-hui, ZHAO Jun, ZHANG Yi-sheng. Comparative study of laparoscopic appendectomy for complicated and uncomplicated acute appendicitis[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(7): 794-799.

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