Conversion rate and risk factors of conversion to open in laparoscopic appendicectomy

• Published in: Annals of coloproctology Vol. 38; no. 6; pp. 409 - 414
• Main Authors: Pushpanathan, Nelson Rao, Hashim, Mohd Nizam Md, Zahari, Zalina, Aziz, Syed Hassan Syed Abd, Zain, Wan Zainira Wan, Ramely, Rosnelifaizur, Wong, Michael Pak-Kai, Mohamad, Ikhwan Sani, Mokhter, Wan Mokhzani Wan, Yahya, Maya Mazuwin, Merican, Siti Rahmah Hashim Isa, Zakaria, Zaidi, Zakaria, Andee Dzulkarnaen
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Coloproctology 01.12.2022
• Subjects: conversion to open; laparoscopic appendicectomy; open appendicectomy; Original; Open appendicectomy; Laparoscopic appendicectomy; Conversion to open
• ISSN: 2287-9714; 2287-9722
• DOI: 10.3393/ac.2020.00437.0062

Laparoscopic appendicectomy (LA) has several advantages over conventional open appendicectomy (OA). However, about 5% to 10% of LA patients still need to be converted to open surgery. Identifying risk factors that contribute to conversion to OA allows for early identification of patients who may benefit from primary OA. This study aimed to determine the conversion rate of LA to OA and to identify its associated risk factors among patients with acute or perforated appendicitis. A retrospective review of medical records was performed among patients with acute or perforated appendicitis who underwent LA between December 2015 and January 2017. With the use of multivariable logistic regression analyses, the predictors of conversion from laparoscopic to OA were investigated. Out of 120 patients, 33 cases were converted to OA which gives a conversion rate of 27.5%. Among 33 patients who were converted to OA, 27 patients (81.8%) had perforated appendix, while in the LA group, perforated appendix cases consisted of 34.5% (P<0.001). Histopathology of the appendix was the predictor of conversion from LA to OA (adjusted odds ratio, 8.82; 95% confidence interval, 3.13-24.91; P<0.001). The result from our study shows that the overall conversion rate for the study period was high. Patients with perforated appendicitis had a higher risk of conversion to OA. Therefore, preoperative diagnosis of perforated appendicitis may be paramount in predicting conversion to OA.