Laparoscopic appendectomy versus open appendectomy: retrospective assessment of 200 patients.

OBJECTIVE

To compare laparoscopic appendectomy (LA) with traditional methods as the primary treatment for acute appendicitis.

DESIGN

A retrospective case series.

SETTING

A regional, nonuniversity hospital in northwestern Quebec.

PATIENTS

Two hundred patients with a clinical diagnosis of acute appendicitis: 100 (43 men, 57 women; mean age 27 years) underwent laparoscopic appendectomy and 100 (67 men, 33 women; mean age 21 years) had an open appendectomy (OA).

INTERVENTIONS

LA or OA.

MAIN OUTCOME MEASURES

Operating time, rate of conversion to OA, need for analgesia, morbidity and outcome.

RESULTS

LA was successful in 88% of patients. The mean operating time was 50 minutes for LA versus 24 minutes for OA. On average, patients of the LA group had a 1-day decrease in postoperative hospital stay (2.6 versus 3.6 days). The wound infection rate was lower in the LA group (2% versus 12%) as was the intra-abdominal abscess rate (2% versus 6.0%). There were no deaths in either group. The overall morbidity was 4.5% for the LA group and 18% for the OA group. A clear tendency toward a shorter convalescence was seen in the LA group.

CONCLUSIONS

LA is a safe and viable treatment alternative for acute appendicitis. Prospective randomized studies are needed to confirm its potential advantages.