The incidence of laparoscopic approach for the surgical treatment of acute appendicitis. A Romanian multicenter prospective study.
EAES Academy. Bintintan V. 07/05/22; 362975; P018
Dr. Vasile Bintintan
Contributions
Contributions
Abstract
Introduction:
Due to lack of a nationwide registry of minimally-invasive operated patients, the real incidence of the laparoscopic approach for treatment of acute appendicitis in Romanian hospitals is not known. The aim of this study is to shed a light on this issue.
Material and method:
A national multicenter study prospective study was conducted during a 6-month period, form 15 May to 15 November and included hospitals of all categories: 6 university hospitals, 9 county hospitals, 6 municipal hospitals and 1 private hospital. Inclusion criteria for the hospitals was the willingness to record data in a prospective manner. All patients with acute appendicitis operated both open and laparoscopic were enrolled in the study.
Results:
588 patients were included din total, of which 562 adults, 6 pregnant women and 20 minors aged between 9 and 17 years. Of these 274 (46.6%) were operated laparoscopically while 313 patients (53.2%) were operated with an open of which 294 with McBurney incision (50%), 19 (3.2%) with Jalaguer incision and 1 (0.2%) oblique inguinal incision. The incidence of laparoscopic appendectomy was 100% in the private hospital, 72,3% in university hospitals, 37.3% in county hospitals and 29.5% in city hospitals. The overall conversion rate was 6.93%. The wound infection rate was significantly higher in the open vs the laparoscopic group (7.9% vs 2.4%). The average postoperative hospital stay was also significantly lower in the laparoscopic group (4 vs 6 days, respectively).
Conclusion:
In this sample of 22 hospitals that cover the entire diversity of Romanian hospitals, the incidence of laparoscopic appendectomy aims towards 50% and is higher than expected. Probably there is a selection bias, probably younger, enthusiastic surgeons were more eager to take part in a prospective trial. However, it shows a trend in Romanian surgery toward modernization that is clearly led by the new, young generation of surgeons now used with minimally-invasive surgery from their training as residents.
Due to lack of a nationwide registry of minimally-invasive operated patients, the real incidence of the laparoscopic approach for treatment of acute appendicitis in Romanian hospitals is not known. The aim of this study is to shed a light on this issue.
Material and method:
A national multicenter study prospective study was conducted during a 6-month period, form 15 May to 15 November and included hospitals of all categories: 6 university hospitals, 9 county hospitals, 6 municipal hospitals and 1 private hospital. Inclusion criteria for the hospitals was the willingness to record data in a prospective manner. All patients with acute appendicitis operated both open and laparoscopic were enrolled in the study.
Results:
588 patients were included din total, of which 562 adults, 6 pregnant women and 20 minors aged between 9 and 17 years. Of these 274 (46.6%) were operated laparoscopically while 313 patients (53.2%) were operated with an open of which 294 with McBurney incision (50%), 19 (3.2%) with Jalaguer incision and 1 (0.2%) oblique inguinal incision. The incidence of laparoscopic appendectomy was 100% in the private hospital, 72,3% in university hospitals, 37.3% in county hospitals and 29.5% in city hospitals. The overall conversion rate was 6.93%. The wound infection rate was significantly higher in the open vs the laparoscopic group (7.9% vs 2.4%). The average postoperative hospital stay was also significantly lower in the laparoscopic group (4 vs 6 days, respectively).
Conclusion:
In this sample of 22 hospitals that cover the entire diversity of Romanian hospitals, the incidence of laparoscopic appendectomy aims towards 50% and is higher than expected. Probably there is a selection bias, probably younger, enthusiastic surgeons were more eager to take part in a prospective trial. However, it shows a trend in Romanian surgery toward modernization that is clearly led by the new, young generation of surgeons now used with minimally-invasive surgery from their training as residents.
Introduction:
Due to lack of a nationwide registry of minimally-invasive operated patients, the real incidence of the laparoscopic approach for treatment of acute appendicitis in Romanian hospitals is not known. The aim of this study is to shed a light on this issue.
Material and method:
A national multicenter study prospective study was conducted during a 6-month period, form 15 May to 15 November and included hospitals of all categories: 6 university hospitals, 9 county hospitals, 6 municipal hospitals and 1 private hospital. Inclusion criteria for the hospitals was the willingness to record data in a prospective manner. All patients with acute appendicitis operated both open and laparoscopic were enrolled in the study.
Results:
588 patients were included din total, of which 562 adults, 6 pregnant women and 20 minors aged between 9 and 17 years. Of these 274 (46.6%) were operated laparoscopically while 313 patients (53.2%) were operated with an open of which 294 with McBurney incision (50%), 19 (3.2%) with Jalaguer incision and 1 (0.2%) oblique inguinal incision. The incidence of laparoscopic appendectomy was 100% in the private hospital, 72,3% in university hospitals, 37.3% in county hospitals and 29.5% in city hospitals. The overall conversion rate was 6.93%. The wound infection rate was significantly higher in the open vs the laparoscopic group (7.9% vs 2.4%). The average postoperative hospital stay was also significantly lower in the laparoscopic group (4 vs 6 days, respectively).
Conclusion:
In this sample of 22 hospitals that cover the entire diversity of Romanian hospitals, the incidence of laparoscopic appendectomy aims towards 50% and is higher than expected. Probably there is a selection bias, probably younger, enthusiastic surgeons were more eager to take part in a prospective trial. However, it shows a trend in Romanian surgery toward modernization that is clearly led by the new, young generation of surgeons now used with minimally-invasive surgery from their training as residents.
Due to lack of a nationwide registry of minimally-invasive operated patients, the real incidence of the laparoscopic approach for treatment of acute appendicitis in Romanian hospitals is not known. The aim of this study is to shed a light on this issue.
Material and method:
A national multicenter study prospective study was conducted during a 6-month period, form 15 May to 15 November and included hospitals of all categories: 6 university hospitals, 9 county hospitals, 6 municipal hospitals and 1 private hospital. Inclusion criteria for the hospitals was the willingness to record data in a prospective manner. All patients with acute appendicitis operated both open and laparoscopic were enrolled in the study.
Results:
588 patients were included din total, of which 562 adults, 6 pregnant women and 20 minors aged between 9 and 17 years. Of these 274 (46.6%) were operated laparoscopically while 313 patients (53.2%) were operated with an open of which 294 with McBurney incision (50%), 19 (3.2%) with Jalaguer incision and 1 (0.2%) oblique inguinal incision. The incidence of laparoscopic appendectomy was 100% in the private hospital, 72,3% in university hospitals, 37.3% in county hospitals and 29.5% in city hospitals. The overall conversion rate was 6.93%. The wound infection rate was significantly higher in the open vs the laparoscopic group (7.9% vs 2.4%). The average postoperative hospital stay was also significantly lower in the laparoscopic group (4 vs 6 days, respectively).
Conclusion:
In this sample of 22 hospitals that cover the entire diversity of Romanian hospitals, the incidence of laparoscopic appendectomy aims towards 50% and is higher than expected. Probably there is a selection bias, probably younger, enthusiastic surgeons were more eager to take part in a prospective trial. However, it shows a trend in Romanian surgery toward modernization that is clearly led by the new, young generation of surgeons now used with minimally-invasive surgery from their training as residents.
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