Results of outpatient laparoscopic appendectomy in women.

The results of laparoscopic appendectomy under outpatient conditions are reported here from a retrospective analysis of the data for 78 women (aged 17-55) selected as having clinically acute or subacute appendicitis. Patients with severe disease presenting with sepsis or peritonitis were excluded, since they were referred to hospital. The duration of the procedure in the 78 women was 30-120 minutes (mean: 45), and only one minor intraoperative complication (a slight lesion to the uterus from the working trocar) was encountered. Follow-up was carried out by daily telephone interviews and a physical examination on the third or fourth postoperative day. Five postoperative complications (four cases of peritonitis and one stump insufficiency) were found two to seven days after the laparoscopic appendectomy, and these had to be treated by laparotomy. No severe sequelae or mortality were encountered. The calculated costs of the laparoscopic approach (DM 1,000.00 in total for anesthesia and operation) compared favorably with a conventional inpatient regimen covering seven days (DM 3,000.00-5000.00). We conclude that laparoscopic appendectomy under outpatient conditions is a safe and cost-effective modality for treating acute and subacute appendicitis in selected patients.