Laparoscopic Versus Open Surgery for Complicated Appendicitis

Goutaro Katsuno, Masaki Fukunaga, Kunihiko Nagakari, Masahiko Sugano, Masaru Suda, Seiichiro Yoshikawa, Yoshitomo Itou and Yoshinori Hirasaki

Department of Surgery, Juntendo Urayasu Hospital, Juntendo University

Background: Although laparoscopic appendectomy (LA) is widely done in many countries, it is rarely conducted for complicated appendicitis involving perforated or gangrenous appendicitis with or without localized or disseminated peritonitis. Methods: We retrospectively analyzed the clinical records of 230 patients who had undergone appendectomy for complicated appendicitis during this study period. Of them, 146 had undergone LA, 84 conventional OA, and 5 patients were converted to the open procedure after laparoscopy (CA). We compared these groups for background factors, intraoperative findings, postoperative findings, and hospital discharge. Results: Patient demographics were similar in the LA and OA groups (p>0.05). Intraoperative blood loss was significantly higher in the open group (p<0.001), even though operating time was slightly longer than in the laparoscopic group (p<0.001). Overall postoperative complications were significantly higher in the open group at 32.1% than in the laparoscopic group at 13.7% (p<0.001). Wound infection was significantly more common in the open group at 23.8% than in the laparoscopic group at 7.5% (p<0.001). Intraabdominal infection was equally common in the two groups. Hospitalization was significantly shorter in the laparoscopic group (p<0.001). Hospital discharge was equal in the two groups. Conclusions: Our findings indicate that LA is safe and useful even in treating complicated appendicitis.

Key words
appendicitis, appendectomy, laparoscopic, open

Reprint requests
Goutaro Katsuno Department of Surgery, Juntendo Urayasu Hospital, Juntendo University
2-1-1 Tomioka, Urayasu, 279-0021 JAPAN

Accepted
July 23, 2008

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