The Comparison of Open and Laparoscopic Appendectomy: Is There any Outcome Difference Between Non-Complicated and Complicated Appendicitis?

Abstract

Objective: The assessment of laparoscopic appendectomy (LA) and open appendectomy (OA) in patients with noncomplicated (NCA) and complicated appendicitis (CA) was aimed for. Material and Methods: Of 279 patients with appendectomy, 135 had NCA (48.3%) (49 underwent LA) (86M, 49F, median 9 years and 144 had CA (51.7%) (23 underwent LA) (98M, 46F, median 11 years). Outcome measures: Wound infection (WI), intraabdominal abscess (IA), postoperative ileus (PI), requirement of reoperation (RO), time of surgery (TOS), length of stay (LOS), duration of postoperative pain (PP), nasogastric tube (NT), intraperitoneal drainage (ID) were recorded. Results: Between OA and LA groups, there was no statistical significance in WI(3/86 vs 0/49), IA(2/86 vs 0/49), RO(2/86 vs 2/49), and PI rate (1/86 vs 2/49) in NCA group (p > 0.05). The LOS(3 +/- 1.4 vs 4 +/- 1.3), NT (1.2 +/- 0.9 vs 1.8 +/- 0.6 days) and PP(0.9 +/- 0.9 vs 2.3 +/- 1.1 days) were lower in LA than OA (p < 0.05). There was no difference in TOS(79.5 +/- 27.3 vs 71.6 +/- 18.9 min) (p > 0.05). In CA, patients with LA had less WI(0/23 vs 18/121) (p < 0.05). NT (2 +/- 0.8 vs 2.7 +/- 1.5), PP (2.1 +/- 1.2 vs 3.2 +/- 1.5) and ID (3.1 +/- 2.3 vs 4.4 +/- 1.4) were lower in LA than OA (p < 0.05). Conclusion: Laparoscopic appendectomy decreases wound infection, nasogastric tube duration, intraperitoneal drainage and pain in complicated appendicitis. The Laporoscopic approach is superior in complicated and noncomplicated appendicitis.