Retrospective Study in Laparoscopic versus Open Appendectomy in Bangkok Metropolitan Administration General Hospital
Article Sidebar
Main Article Content
Abstract
Objective: To compare the result of appendicitis treatment between laparoscopic surgery (LA) and open surgery (OA). In term of duration of hospital stay, intraoperative time, postoperative pain, hospital and medical expenses.
Materials and methods: A retrospective study by reviewing medical records of appendicitis patients who were treated from 1st January, 2011 to 31st December, 2013. The data included personal information, intraoperative details, postoperative details and the data of those was analyzed and was compared between open and laparoscopic surgery.
Results: From the collecting data, 560 patients (433 patients from open surgery and 122 from laparoscopic surgery were studied retrospectively. According to this study, laparoscopic appendectomy was associated with a less blood loss (10 mL in LA and 19 mL in OA, p-value = 0.017, 95% CI = -16.181-(-1.564)), shorter hospital stay (3.1 in LA and 3.6 in OA, p-value = 0.039, 95% CI = -0.969-(-0.004)), and lower postoperative pain from day 1 to day 3 (p-value = <0.001, 95% CI = -0.673-(-0.327), p-value = <0.001, 95% CI = -0.948- (-0.521), and p-value = <0.001, 95% CI = -1.421-(-0.894), respectively). In contrast, intraoperative time in laparoscopic surgery was longer than open surgery significantly (73 min in LA and 54 min in OA, p-value = <0.001, 95% CI = 14.096- 23.566) and cost was higher, too (p-value = <0.001, 95% CI = 7819-11891 ). All factors were statistically significant.
Conclusion: The treatment of appendicitis by using laparoscopic surgery provides a better result in the term of duration of hospital stay, recovering time, postoperative pain but it requires more operative time and more cost too.
Article Details
References
Semm K. Endoscopic appendectomy. Endoscopy 1983;15:59-64.
Martin LC, Puente I, Sosa JL, Bassin A, Breslaw R, McKenney MG, et al. Open versus laparoscopic appendectomy. A prospective randomized comparison. Ann Surg. 1995;222:256–62.
Frazee RC, Roberts JW, Symmonds RE, Okeson GC, Snyder SK, Smith RW, et al. A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg.1994;219:725–31.
Hyun NB, Yong HJ, Yong HH. Laparoscopic versus open appendectomy for appendicitis in elderly patients. J Korean Soc Coloproctol. 2011;27:241–5.
Yong JS, Seung YJ, Kyu JP , Jae GP, Sung BK, Duck WK, et al. Comparison of surgical-site infection between open and laparoscopic appendectomy. J Korean Surg Soc. 2012;82:35–9.
Jenwitheesuk K, Chotikawanich E, Saeseow OT, Thanapaisal C, Punchai S, Paonariang K. Laparoscopic appendectomy: results of a new technique for stump management. J Med Assoc Thai. 2012;1:7-10.
Masoomi H, Nguyen NT, Dolich MO, Mills S, Carmichael JC, Stamos MJ. Laparoscopic appendectomy trends and outcomes in the United States: data from the Nationwide Inpatient Sample (NIS), 2004-2011. Am Surg.2014;80:1074-7.
Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a metaanalysis. J Am Coll Surg. 1998;186:545-53.
Chung RS, Rowland DY, Li P, Diaz J. A metaanalysis of ran- domized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg. 1999;177:250-6.
Garbutt JM, Soper NJ, Shannon WD, Botero A, Littenberg B. Meta-analysis of randomized controlled trials comparing laparoscopic and open appendectomy. Surg Laparosc Endosc.1999;9:17-26.
Yeom S, Kim MS, Park S, Son T, Jung YY, Lee SA et al. Comparison of the outcomes of laparoscopic and open approaches in the treatment of periapendiceal abscess diagnosed by radiologic investigation. J Laparoendosc Adv Surg Tech A. 2014;24:762-9.
Takami T, Yamaguchi T, Yoshitake H, Hatano K, Kataoka N, Tomita M, et al. A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study. Eur J Trauma Emerg Surg.2019;1-5.
Antonio B, Carla DS, Francesco F, Angelo B, Marco V, Luigi P. Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness. World J Emer Surg. 2016;11:1-6.
Witayapairoj J, Janviteesuk K. Laparoscopic appendectomy. Srinagarind Med J. 2013;28:127-34.
Sauerland S, Jaschinski T, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2018.
Cai YL, Xiong XZ, Wu SJ, Cheng Y, Lu J, Zhang J. et al. Single-incision laparoscopic appendectomy vs conventional laparoscopic appendectomy: Systematic review and meta-analysis. World J Gastroenterol. 2013;19:5165–73.
Liu Y, Cui Z, Zhamg R. Laparoscopic versus open appendectomy for acute appendicitis in children. Indian Pediatric. 2017;11:938-41.
Athanasiou C, Lockwood S, Markides GA. Systematic review and meta-analysis of laparoscopic versus open appendicectomy in adults with complicated appendicitis: an update of the literature. World J Surg. 2017;12:3083-99.