Laparoscopic versus open appendectomy: prospective randomized trial

A prospective randomized trial comparing laparoscopic appendectomy with open appendectomy in patients with a diagnosis of acute appendicitis was conducted between October 1992 and April 1994. Of the 158 patients randomized, 7 patients were excluded because of protocol violations (conversion to lapar...

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Bibliographic Details
Published inWorld journal of surgery Vol. 20; no. 1; p. 17
Main Authors Hansen, J B, Smithers, B M, Schache, D, Wall, D R, Miller, B J, Menzies, B L
Format Journal Article
LanguageEnglish
Published United States 01.01.1996
Subjects
Adolescent
Adult
Aged
Appendectomy - economics
Appendectomy - methods
Appendicitis - surgery
Female
Humans
Laparoscopy - economics
Male
Middle Aged
Prospective Studies
Surgical Wound Infection - etiology
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Summary:A prospective randomized trial comparing laparoscopic appendectomy with open appendectomy in patients with a diagnosis of acute appendicitis was conducted between October 1992 and April 1994. Of the 158 patients randomized, 7 patients were excluded because of protocol violations (conversion to laparotomy in 4, appendix not removed in 3). The 151 patients randomized to either a laparoscopic (n = 79) or an open appendectomy (n = 72) showed no difference in sex, age, American Society of Anesthesiology (ASA) rating, or previous abdominal surgery. The histologic classification of normal, catarrhal, inflamed, suppurative, and gangrenous appendicitis was not different between the two groups. Conversion from laparoscopic to open appendectomy was necessary in seven patients (9%) who had advanced forms of appendiceal inflammation. When compared to open appendectomy the laparoscopic group had a longer median operating time (63 minutes versus 40 minutes), fewer wound infections (2% versus 11%), less requirement for narcotic analgesia, and an earlier return to normal activity (median 7 days versus 14 days). There was no difference in morbidity, and both groups had a median time to discharge of 3 days. Laparoscopic appendectomy is as safe as open appendectomy; and despite the longer operating time, the advantages such as fewer wound infections and earlier return to normal activity make it a worthwhile alternative for patients with a clinical diagnosis of acute appendicitis.
ISSN:0364-2313
DOI:10.1007/s002689900003