Acute Appendicitis, should it always be performed laparoscopically?
EAES Academy. Gavilán Parras J. 07/05/22; 362983; P026
Mr. Julio Gavilán Parras
Contributions
Contributions
Abstract
Aim:
Acute appendicitis is one of the most frequent surgical emergencies, the laparoscopic technique is the most widely accepted approach. However, after the publication of some articles defining a higher rate of intra-abdominal complications after laparoscopy, there is still some controversy on which technique should become the gold standard. The objective of this study is to compare the results obtained by our service and compare the techniques.
Methods:
We have designed a cohort study, patients intervened with appendectomy in 2021 in the Hospital of Jerez De La Frontera were included. We analysed the cohorts depending on the technique using SPSS version 22., the variables we studied were: Length of stay, appearance of complications (within 30 days), need for postoperative antibiotics and Clavien-Dindo Score.
Results:
We performed a total of 190 appendectomies in 2021, 41 of which were performed through open surgery and 149 laparoscopically. The open surgery group (OS) had a mean stay of 3.5 (SD 3.4) days while the Laparoscopic group (LA) had a mean stay of 3 (SD 2.9) days (P=0.3). 6 patients (14%) who underwent OS suffered from postoperative complications while the LA group registered 16 (10.7 %) patients who suffered them (P=0.5) (Chart 1). Antibiotics were needed in 17 (41.5%) patients after the intervention in the OS cohort and in 48 (32.2%) in the LA group (P=0.25). Scores in the Clavien-Dindo Classification were below II in 36 (87.7%) patients in the OS group and in 141 (94.6%) in the LA group. The OS cohort had 5 (12.3%) patients scoring III with no one scoring over IV, whereas 6 (4%) patients scored III in the LA group. Two patients scored over III in the LA group; one needed intensive care after a postoperative cecal fistula, one death was registered due to an aggressive leukaemia(P=0.3) (Chart 2).
Conclusion:
Although no statistical differences were found, clinical results are more favourable in those patients who underwent the laparoscopic intervention, as this intervention has proved to reduce hospital stay and postoperative pain, we recommend to choose the laparoscopic approach for appendix surgery.
Acute appendicitis is one of the most frequent surgical emergencies, the laparoscopic technique is the most widely accepted approach. However, after the publication of some articles defining a higher rate of intra-abdominal complications after laparoscopy, there is still some controversy on which technique should become the gold standard. The objective of this study is to compare the results obtained by our service and compare the techniques.
Methods:
We have designed a cohort study, patients intervened with appendectomy in 2021 in the Hospital of Jerez De La Frontera were included. We analysed the cohorts depending on the technique using SPSS version 22., the variables we studied were: Length of stay, appearance of complications (within 30 days), need for postoperative antibiotics and Clavien-Dindo Score.
Results:
We performed a total of 190 appendectomies in 2021, 41 of which were performed through open surgery and 149 laparoscopically. The open surgery group (OS) had a mean stay of 3.5 (SD 3.4) days while the Laparoscopic group (LA) had a mean stay of 3 (SD 2.9) days (P=0.3). 6 patients (14%) who underwent OS suffered from postoperative complications while the LA group registered 16 (10.7 %) patients who suffered them (P=0.5) (Chart 1). Antibiotics were needed in 17 (41.5%) patients after the intervention in the OS cohort and in 48 (32.2%) in the LA group (P=0.25). Scores in the Clavien-Dindo Classification were below II in 36 (87.7%) patients in the OS group and in 141 (94.6%) in the LA group. The OS cohort had 5 (12.3%) patients scoring III with no one scoring over IV, whereas 6 (4%) patients scored III in the LA group. Two patients scored over III in the LA group; one needed intensive care after a postoperative cecal fistula, one death was registered due to an aggressive leukaemia(P=0.3) (Chart 2).
Conclusion:
Although no statistical differences were found, clinical results are more favourable in those patients who underwent the laparoscopic intervention, as this intervention has proved to reduce hospital stay and postoperative pain, we recommend to choose the laparoscopic approach for appendix surgery.
Aim:
Acute appendicitis is one of the most frequent surgical emergencies, the laparoscopic technique is the most widely accepted approach. However, after the publication of some articles defining a higher rate of intra-abdominal complications after laparoscopy, there is still some controversy on which technique should become the gold standard. The objective of this study is to compare the results obtained by our service and compare the techniques.
Methods:
We have designed a cohort study, patients intervened with appendectomy in 2021 in the Hospital of Jerez De La Frontera were included. We analysed the cohorts depending on the technique using SPSS version 22., the variables we studied were: Length of stay, appearance of complications (within 30 days), need for postoperative antibiotics and Clavien-Dindo Score.
Results:
We performed a total of 190 appendectomies in 2021, 41 of which were performed through open surgery and 149 laparoscopically. The open surgery group (OS) had a mean stay of 3.5 (SD 3.4) days while the Laparoscopic group (LA) had a mean stay of 3 (SD 2.9) days (P=0.3). 6 patients (14%) who underwent OS suffered from postoperative complications while the LA group registered 16 (10.7 %) patients who suffered them (P=0.5) (Chart 1). Antibiotics were needed in 17 (41.5%) patients after the intervention in the OS cohort and in 48 (32.2%) in the LA group (P=0.25). Scores in the Clavien-Dindo Classification were below II in 36 (87.7%) patients in the OS group and in 141 (94.6%) in the LA group. The OS cohort had 5 (12.3%) patients scoring III with no one scoring over IV, whereas 6 (4%) patients scored III in the LA group. Two patients scored over III in the LA group; one needed intensive care after a postoperative cecal fistula, one death was registered due to an aggressive leukaemia(P=0.3) (Chart 2).
Conclusion:
Although no statistical differences were found, clinical results are more favourable in those patients who underwent the laparoscopic intervention, as this intervention has proved to reduce hospital stay and postoperative pain, we recommend to choose the laparoscopic approach for appendix surgery.
Acute appendicitis is one of the most frequent surgical emergencies, the laparoscopic technique is the most widely accepted approach. However, after the publication of some articles defining a higher rate of intra-abdominal complications after laparoscopy, there is still some controversy on which technique should become the gold standard. The objective of this study is to compare the results obtained by our service and compare the techniques.
Methods:
We have designed a cohort study, patients intervened with appendectomy in 2021 in the Hospital of Jerez De La Frontera were included. We analysed the cohorts depending on the technique using SPSS version 22., the variables we studied were: Length of stay, appearance of complications (within 30 days), need for postoperative antibiotics and Clavien-Dindo Score.
Results:
We performed a total of 190 appendectomies in 2021, 41 of which were performed through open surgery and 149 laparoscopically. The open surgery group (OS) had a mean stay of 3.5 (SD 3.4) days while the Laparoscopic group (LA) had a mean stay of 3 (SD 2.9) days (P=0.3). 6 patients (14%) who underwent OS suffered from postoperative complications while the LA group registered 16 (10.7 %) patients who suffered them (P=0.5) (Chart 1). Antibiotics were needed in 17 (41.5%) patients after the intervention in the OS cohort and in 48 (32.2%) in the LA group (P=0.25). Scores in the Clavien-Dindo Classification were below II in 36 (87.7%) patients in the OS group and in 141 (94.6%) in the LA group. The OS cohort had 5 (12.3%) patients scoring III with no one scoring over IV, whereas 6 (4%) patients scored III in the LA group. Two patients scored over III in the LA group; one needed intensive care after a postoperative cecal fistula, one death was registered due to an aggressive leukaemia(P=0.3) (Chart 2).
Conclusion:
Although no statistical differences were found, clinical results are more favourable in those patients who underwent the laparoscopic intervention, as this intervention has proved to reduce hospital stay and postoperative pain, we recommend to choose the laparoscopic approach for appendix surgery.
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