Comparison of laparoscopic appendectomy in uncomplicated and complicated appendicitis in General and Teaching Hospital Izola
Abstract
Background: Laparoscopic appendectomy has been gaining ground as a gold standard for the treatment of acute appendicitis. For complex inflammation there is no common opinion. A higher conversion rate, longer operative time, higher incidence of abscess formation and longer hospitalization are being reported. The aim of our study was to compare the diagnostic modalities, treatment and postoperative complications in uncomplicated and complicated appendicitis.
Methods: In our institution laparoscopic appendectomy is the method of choice for the treatment of every type of appendicitis. In our retrospective analysis, all patients with acute appendicitis operated on in the years 2013 and 2014 were included. Among 273 patients, 19 were excluded due to primary open procedure and one who underwent revision surgery for other disease and had appendectomy performed. In 253 patients we observed the proportion of the postoperative complications in uncomplicated and complicated cases with respect to patients’ age, period of the year, duration of hospital stay, diagnostic modalities, drainage of the abdominal cavity, conversion rate and stump closure.
Results: The analysis showed a steep increase of complicated appendicitis in elderly population, but there were no significant differences regarding period of the year (χ2 test, p = 0.158). The hospital stay was longer in complicated cases (5.94 days v. 3.049 days). When a preoperative CT scan was performed, cases were more often complicated (CT 0.654, no CT 0.229; χ2 test, p < 0.001), as was the proportion of drain insertions during surgery (0.5490 v. 0.065; χ2 test, p < 0.001). The proportion of clips for the stump closure was higher in the uncomplicated group (0.717 v. 0.521; χ2 test, p = 0.005). The rate of early postoperative complications and conversion rate revealed no significant difference.
Conclusions: We have found out there is a difference in diagnostic modalities and treatment options in uncomplicated and complicated appendicitis, but no significant difference in the conversion rate and early postoperative complications. Our analysis suggests that laparoscopic appendectomy is a safe method in all types of appendicitis.
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