Laparoscopic versus Conventional Open Appendectomy for Appendicitis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 DUYa-qiong , HUABao , WUJu-gang , NIXiao-chun , WANGShou-lian , JIANGBo-jian ,  YUJi-wei

Department of General Surgery, Ninth People's Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 201999, China;

Corresponding author：

YUJi-wei, Email: jenniferyu919@126.com

Keywords：

Acute appendicitis; Laparoscopic appendectomy; Open appendectomy; postoperative complication

DOI：

10.7507/1007-9424.20160316

Video：

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Objective To compare the outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) for the acute appendicitis patients based on our extensive experiences. Methods The data of all the acute appendicitis patients who underwent appendectomy from January 2013 to December 2014 in our department were retrospectively reviewed. A total of 201 patients were enrolled and divided into LA group (n=102) and OA group (n=99). The relevant clinical indexes during and after operation of two groups were compared. Results There were no significant difference in age, gender, and underlying disease between LA and OA patients (P > 0.05). And the abdominal cavity infection rate, abdominal drainage rate and 30-day readmission rate were also similar (P > 0.05). But LA group had less operative time, lower infection operative wound rate, less intestinal function recovery time, shorter inhospital days and higher hospital expenses than OA group (P < 0. 05). In addition, perforated appendix and LA could increase the rate of abdominal drainage[OR=2.710, 95% CI(1.129, 6.507), P=0.026]. Conclusions Both LA and OA are safe and effective methods for the treatment of acute appendicitis. But LA has several advantages over OA on less operative time and postoperative complications, earlier recovery, and shorter inhospital days. While LA have higher hospital cost than OA, it still should be considered as a prefer way to cure acute appendicitis. LA is a independent risk factor of abdominal drainage.

Citation： DU Ya-qiong, HUA Bao, WU Ju-gang, NI Xiao-chun, WANG Shou-lian, JIANG Bo-jian, YU Ji-wei. Laparoscopic versus Conventional Open Appendectomy for Appendicitis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(10): 1231-1235. doi: 10.7507/1007-9424.20160316 Copy

1.	McBurney C. Ⅳ. The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg, 1894, 20(1):38-43.
2.	Madore JC, Collins CE, Ayturk MD, et al. The impact of acute care surgery on appendicitis outcomes:results from a national sample of university-affiliated hospitals. J Trauma Acute Care Surg, 2015, 79(2):282-288.
3.	Cheng HT, Wang YC, Lo HC, et al. Laparoscopic appendectomy versus open appendectomy in pregnancy:a population-based analysis of maternal outcome. Surg Endosc, 2015, 29(6):1394-1399.
4.	Semm K, Endoscopic appendectomy. Endoscopy, 1983, 15(2):59-64.
5.	Thomson JE, Kruger D, Jann-Kruger C, et al. Laparoscopic versus open surgery for complicated appendicitis:a randomized controlled trial to prove safety. Surg Endosc, 2015, 29(7):2027-2032.
6.	Jaschinski T, Mosch C, Eikermann M, et al. Laparoscopic versus open appendectomy in patients with suspected appendicitis:a systematic review of meta-analyses of randomised controlled trials. BMC Gastroenterol, 2015, 15:48.
7.	Cipe G, Idiz O, Hasbahceci M, et al. Laparoscopic versus open appendectomy:where are we now? Chirurgia (Bucur), 2014, 109(4):518-522.
8.	Casarotto A, Zarantonello FR, Rebonato M. Appendectomy in women. Is the laparoscopic approach always better than the "open" approach in uncomplicated appendicitis? Surg Laparosc Endosc Percutan Tech, 2014, 24(5):406-409.
9.	Gosemann JH, Lange A, Zeidler J, et al. Appendectomy in the pediatric population:a German nationwide cohort analysis. Langenbecks Arch Surg, 2016, 401(5):651-659.
10.	Laustsen JF, Bjerring OS, Johannessen Ø, et al. Laparoscopic appendectomy during pregnancy is safe for both the mother and the fetus. Dan Med J, 2016, 63(8):pii:A5259.
11.	Bliss LA, Yang CJ, Kent TS, et al. Appendicitis in the modern era:universal problem and variable treatment. Surg Endosc, 2015, 29(7):1897-1902.
12.	Fleming FJ, Kim MJ, Messing S, et al. Balancing the risk of postoperative surgical infections:a multivariate analysis of factors associated with laparoscopic appendectomy from the NSQIP database. Ann Surg, 2010, 252(6):895-900.
13.	Oravsky M, Bak V, Schnorrer M. Laparoscopic versus open appendectomy in treatment of acute appendicitis. Bratisl Lek Listy, 2014, 115(10):660-662.
14.	Kargar S, Mirshamsi MH, Zare M, et al. Laparoscopic versus open appendectomy; which method to choose? A prospective randomized comparison. Acta Med Iran, 2011, 49(6):352-356.
15.	Fair BA, Kubasiak JC, Janssen I, et al. The impact of operative timing on outcomes of appendicitis:a National Surgical Quality Improvement Project analysis. Am J Surg, 2015, 209(3):498-502.
16.	Horvath P, Lange J, Bachmann R, et al. Comparison of clinical outcome of laparoscopic versus open appendectomy for complicated appendicitis. Surg Endosc, 2016 May 18.[Epub ahead of print].
17.	Kuwabara K, Imanaka Y, Matsuda S, et al. Cost of open versus laparoscopic appendectomy. Clin Ter, 2008, 159(3):155-163.
18.	Russell KW, Rollins MD, Barnhart DC, et al. Charge awareness affects treatment choice:prospective randomized trial in pediatric appendectomy. Ann Surg, 2015, 262(1):189-193.
19.	Lin KB, Lai KR, Yang NP, et al. Trends and outcomes in the utilization of laparoscopic appendectomies in a low-income population in Taiwan from 2003 to 2011. Int J Equity Health, 2015, 14:100.
20.	Katkhouda N, Mason RJ, Towfigh S, et al. Laparoscopic versus open appendectomy:a prospective randomized double-blind study. Ann Surg, 2005, 242(3):439-448; discussion 448-450.
21.	Clarke T, Katkhouda N, Mason RJ, et al. Laparoscopic versus open appendectomy for the obese patient:a subset analysis from a prospective, randomized, double-blind study. Surg Endosc, 2011, 25(4):1276-1280.
22.	Lin YM, Hsieh CH, Cheng CI, et al. Laparoscopic appendectomy for complicated acute appendicitis does not result in increased surgical complications. Asian J Surg, 2012, 35(3):113-116.
23.	Quezada F, Quezada N, Mejia R, et al. Laparoscopic versus open approach in the management of appendicitis complicated exclusively with peritonitis:a single center experience. Int J Surg, 2015, 13:80-83.
24.	Dasari BV, Baker J, Markar S, et al. Laparoscopic appendicectomy in obese is associated with improvements in clinical outcome:systematic review. Int J Surg, 2015, 13:250-256.
25.	Werkgartner G, Cerwenka H, El Shabrawi A, et al. Laparoscopic versus open appendectomy for complicated appendicitis in high risk patients. Int J Colorectal Dis, 2015, 30(3):397-401.

1. McBurney C. Ⅳ. The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg, 1894, 20(1):38-43.
2. Madore JC, Collins CE, Ayturk MD, et al. The impact of acute care surgery on appendicitis outcomes:results from a national sample of university-affiliated hospitals. J Trauma Acute Care Surg, 2015, 79(2):282-288.
3. Cheng HT, Wang YC, Lo HC, et al. Laparoscopic appendectomy versus open appendectomy in pregnancy:a population-based analysis of maternal outcome. Surg Endosc, 2015, 29(6):1394-1399.
4. Semm K, Endoscopic appendectomy. Endoscopy, 1983, 15(2):59-64.
5. Thomson JE, Kruger D, Jann-Kruger C, et al. Laparoscopic versus open surgery for complicated appendicitis:a randomized controlled trial to prove safety. Surg Endosc, 2015, 29(7):2027-2032.
6. Jaschinski T, Mosch C, Eikermann M, et al. Laparoscopic versus open appendectomy in patients with suspected appendicitis:a systematic review of meta-analyses of randomised controlled trials. BMC Gastroenterol, 2015, 15:48.
7. Cipe G, Idiz O, Hasbahceci M, et al. Laparoscopic versus open appendectomy:where are we now? Chirurgia (Bucur), 2014, 109(4):518-522.
8. Casarotto A, Zarantonello FR, Rebonato M. Appendectomy in women. Is the laparoscopic approach always better than the "open" approach in uncomplicated appendicitis? Surg Laparosc Endosc Percutan Tech, 2014, 24(5):406-409.
9. Gosemann JH, Lange A, Zeidler J, et al. Appendectomy in the pediatric population:a German nationwide cohort analysis. Langenbecks Arch Surg, 2016, 401(5):651-659.
10. Laustsen JF, Bjerring OS, Johannessen Ø, et al. Laparoscopic appendectomy during pregnancy is safe for both the mother and the fetus. Dan Med J, 2016, 63(8):pii:A5259.
11. Bliss LA, Yang CJ, Kent TS, et al. Appendicitis in the modern era:universal problem and variable treatment. Surg Endosc, 2015, 29(7):1897-1902.
12. Fleming FJ, Kim MJ, Messing S, et al. Balancing the risk of postoperative surgical infections:a multivariate analysis of factors associated with laparoscopic appendectomy from the NSQIP database. Ann Surg, 2010, 252(6):895-900.
13. Oravsky M, Bak V, Schnorrer M. Laparoscopic versus open appendectomy in treatment of acute appendicitis. Bratisl Lek Listy, 2014, 115(10):660-662.
14. Kargar S, Mirshamsi MH, Zare M, et al. Laparoscopic versus open appendectomy; which method to choose? A prospective randomized comparison. Acta Med Iran, 2011, 49(6):352-356.
15. Fair BA, Kubasiak JC, Janssen I, et al. The impact of operative timing on outcomes of appendicitis:a National Surgical Quality Improvement Project analysis. Am J Surg, 2015, 209(3):498-502.
16. Horvath P, Lange J, Bachmann R, et al. Comparison of clinical outcome of laparoscopic versus open appendectomy for complicated appendicitis. Surg Endosc, 2016 May 18.[Epub ahead of print].
17. Kuwabara K, Imanaka Y, Matsuda S, et al. Cost of open versus laparoscopic appendectomy. Clin Ter, 2008, 159(3):155-163.
18. Russell KW, Rollins MD, Barnhart DC, et al. Charge awareness affects treatment choice:prospective randomized trial in pediatric appendectomy. Ann Surg, 2015, 262(1):189-193.
19. Lin KB, Lai KR, Yang NP, et al. Trends and outcomes in the utilization of laparoscopic appendectomies in a low-income population in Taiwan from 2003 to 2011. Int J Equity Health, 2015, 14:100.
20. Katkhouda N, Mason RJ, Towfigh S, et al. Laparoscopic versus open appendectomy:a prospective randomized double-blind study. Ann Surg, 2005, 242(3):439-448; discussion 448-450.
21. Clarke T, Katkhouda N, Mason RJ, et al. Laparoscopic versus open appendectomy for the obese patient:a subset analysis from a prospective, randomized, double-blind study. Surg Endosc, 2011, 25(4):1276-1280.
22. Lin YM, Hsieh CH, Cheng CI, et al. Laparoscopic appendectomy for complicated acute appendicitis does not result in increased surgical complications. Asian J Surg, 2012, 35(3):113-116.
23. Quezada F, Quezada N, Mejia R, et al. Laparoscopic versus open approach in the management of appendicitis complicated exclusively with peritonitis:a single center experience. Int J Surg, 2015, 13:80-83.
24. Dasari BV, Baker J, Markar S, et al. Laparoscopic appendicectomy in obese is associated with improvements in clinical outcome:systematic review. Int J Surg, 2015, 13:250-256.
25. Werkgartner G, Cerwenka H, El Shabrawi A, et al. Laparoscopic versus open appendectomy for complicated appendicitis in high risk patients. Int J Colorectal Dis, 2015, 30(3):397-401.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic versus Conventional Open Appendectomy for Appendicitis

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