Skip to main content
SpringerLink
Log in

Laparoscopic appendectomy is the preferred approach for appendicitis: a retrospective review of two practice patterns

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

This study aimed to compare the results of laparoscopic appendectomy (LA) and open appendectomy (OA).

Methods

A retrospective analysis of 264 patients who underwent appendectomy (155 LA and 109 OA) over an 8-year period was performed. The variables analyzed included patient data (white blood cell count [WBC], duration of symptoms, American Society of Anesthesiology [ASA] score), operating data (length of the procedure and pathology), postoperative data (postoperative complications and length of hospital stay), and total costs.

Results

Patient demographic data (age and sex), preoperative WBC, duration of symptoms, and pathology all were similar in the two study groups. Six cases were converted to OA and included in the LA group data. There was no statistical difference in the average operative time between the LA (mean, 55.7 ± 22.3 min; range, 20–128 min) and OA (mean, 58.9 ± 23.7 min; range, 29–135 min) groups (95% confidence interval [CI] –8.8–2.43; p = 0.26). The overall incidence of minor and major complications was significantly less in the LA group (3.2%, five incidents) than in the OA group (17.4%, 19 incidents; p = 0.0043). The median length of hospital stay (LOS) was significantly shorter in the laparoscopic group (median, 2 days; range, 1–8 days) than in the open group (median, 3 days; range, 1–11 days; p < 0.001). The mean total cost was $5,663 in the laparoscopic group and $6,031 in the open group (non-significant difference of –$368; 95% CI, –$926–$190; p = 0.19).

Conclusion

The findings show that LA is associated with fewer complications and similar total costs compared with OA. Therefore, LA can be recommended as a preferred approach to appendectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Semm K (1983) Endoscopic appendectomy. Endoscopy 15:59–64

    Article  CAS  PubMed  Google Scholar 

  2. Cox MR, McCall JL, Toouli J, Padbury RTA, Wilson TG, Wattchow DA et al (1996) Prospective randomized comparison of open versus laparoscopic appendectomy in men. World J Surg 20:263–266

    Article  CAS  PubMed  Google Scholar 

  3. Frazee RC, Roberts JW, Symmonds RE, Snyder SK, Hendricks JC, Smith RW et al (1994) A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg 219:725–731

    Article  CAS  PubMed  Google Scholar 

  4. Hansen JB, Smithers BM, Schache D, Wall DR, Miller BJ, Menzies BL (1996) Laparoscopic versus open appendectomy: prospective randomized trial. World J Surg 20:17–21

    Article  CAS  PubMed  Google Scholar 

  5. Schein M, Marshall J (2004) Source control for surgical infections. World J Surg 28:638–645

    PubMed  Google Scholar 

  6. Kum CK, Ngoi SS, Goh PMY, Tekant Y, Isaac JR (1993) Randomized controlled trial comparing laparoscopic and open appendectomy. Br J Surg 80:1599–1600

    Article  CAS  PubMed  Google Scholar 

  7. McAnena OJ, Austin O, O’Connel PR, Hederman WP, Gorey TF, Fitzpatrick J (1992) Laparoscopic versus open appendectomy: a prospective evaluation. Br J Surg 79:818–820

    Article  CAS  PubMed  Google Scholar 

  8. Ortega AE, Hunter JG, Peters JH, Swanstrom LL, Schirmer B, The Laparoscopic Appendectomy Study Group (1995) A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Am J Surg 169:208–213

    Article  CAS  PubMed  Google Scholar 

  9. Attwood SE, Hill AD, Murphy PG, Thornton J, Stephens RB (1992) A prospective randomized trial of laparoscopic versus open appendectomy. Surgery 112:497–501

    CAS  PubMed  Google Scholar 

  10. Hart R, Rajgopal C, Plewes A, Sweeney J, Davies W, Gray D et al (1996) Laparoscopic versus open appendectomy: a prospective randomized trial of 81 patients. Can J Surg 39:457–462

    CAS  PubMed  Google Scholar 

  11. Hellberg A, Rudberg C, Kullman E, Enochsson L, Fenyo G, Graffner H, Hallerback B, Johansson B, Anderberg B, Wenner J, Ringqvist I, Sorensen S (1999) Prospective randomized multicentre study of laparoscopic versus open appendicectomy. Br J Surg 86:48–53

    Article  CAS  PubMed  Google Scholar 

  12. Heikkinen TJ, Haukipuro K, Hulkko A (1998) Cost-effective appendectomy: open or laparoscopic? A prospective randomized study. Surg Endosc 12:1204–1208

    Article  CAS  PubMed  Google Scholar 

  13. Reiertsen O, Larsen S, Trondsen E, Edwin B, Farden AE, Rosseland AR (1997) Randomized controlled trial with sequential design of laparoscopic versus conventional appendectomy. Br J Surg 84:842–847

    Article  CAS  PubMed  Google Scholar 

  14. Laine S, Rantala A, Gullichsen R, Ovaska J (1997) Laparoscopic appendectomy: is it worthwhile? A prospective, randomized study in young women. Surg Endosc 11:95–97

    Article  CAS  PubMed  Google Scholar 

  15. Enochsson L, Hellberg A, Rudberg C et al (2001) Laparoscopic vs open appendectomy in overweight patients. Surg Endosc 15:387–392

    Article  CAS  PubMed  Google Scholar 

  16. Frizelle FA, Hanna GB (1996) Pelvic abscess following laparoscopic appendectomy. Surg Endosc 10:947–948

    CAS  PubMed  Google Scholar 

  17. Tang E, Ortega AE, Anthone GJ, Beart RW Jr (1996) Intraabdominal abscesses following laparoscopic and open appendectomies. Surg Endosc 10:327–328

    Article  CAS  PubMed  Google Scholar 

  18. Pedersen AG, Petersen OB, Wara P, Ronning H, Qvist N, Laurberg S (2001) Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg 88:200–205

    Article  CAS  PubMed  Google Scholar 

  19. Lujan Mompean JA, Robles Campos R, Parrilla Paricio P, Soria Aledo V, Garcia Ayllon J (1994) Laparoscopic versus open appendectomy: a prospective assessment. Br J Surg 81:133–135

    Article  CAS  PubMed  Google Scholar 

  20. Paya K, Rauhofer U, Rebhandl W, Deluggi S, Horcher E (2000) Perforating appendicitis: an indication for laparoscopy? Surg Endosc 14:182–184

    Article  CAS  PubMed  Google Scholar 

  21. Long KH, Bannon MP, Zietlow SP et al (2001) A prospective randomized comparison of laparoscopic appendectomy with open appendectomy: clinical and economic analyses. Surgery 129:390–400

    CAS  PubMed  Google Scholar 

  22. Jaffer U, Cameron AE (2008) Laparoscopic appendectomy: a junior trainee’s learning curve. JSLS 12:288–291

    PubMed  Google Scholar 

  23. Kald A, Kullman E, Anderberg B, Wiren M, Carlsson P, Ringqvist I, Rudberg C (1999) Cost-minimisation analysis of laparoscopic and open appendectomy. Eur J Surg 165:579–582

    Article  CAS  PubMed  Google Scholar 

  24. Kuwabara K, Imanaka Y, Matsuda S, Fushimi K, Hashimoto H, Ishikawa KB, Horiguchi H, Hayashida K, Fujimor K (2008) Cost of open versus laparoscopic appendectomy. Clin Ter 159:155–163

    CAS  PubMed  Google Scholar 

  25. Cothren CC, Moore EE, Johnson JL, Moore JB, Ciesla DJ, Burch JM (2005) Can we afford to do laparoscopic appendectomy in an academic hospital? Am J Surg 190:950–954

    PubMed  Google Scholar 

  26. Ignacio RC, Burke R, Spencer D, Bissell C, Dorsainvil C, Lucha PA (2004) Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc 18:334–337

    Article  CAS  PubMed  Google Scholar 

  27. Minné L, Varner D, Burnell A, Ratzer E, Clark J, Haun W (1997) Laparoscopic vs open appendectomy: prospective randomized study of outcomes. Arch Surg 132:708–711

    PubMed  Google Scholar 

  28. Sporn E, Petroski GF, Mancini GJ, Astudillo JA, Miedema BW, Thaler K (2009) Laparoscopic appendectomy: is it worth the cost? Trend Analysis in the US from 2000 to 2005. J Am Coll Surg 208:179–185

    Article  PubMed  Google Scholar 

  29. Varela JE, Hinojosa MW, Nguyen NT (2008) Laparoscopy should be the approach of choice for acute appendicitis in the morbidly obese. Am J Surg 196:218–222

    Article  PubMed  Google Scholar 

  30. Martin LC, Puente I, Sosa JL, Bassin A, Breslaw R, McKenney MG, Ginzburg E, Sleeman D (1995) Open versus laparoscopic appendectomy: a prospective randomized comparison. Ann Surg 222:256–261

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, New York Methodist Hospital, 506 Sixth Street, Brooklyn, NY, 11215, USA

    Vadim Nakhamiyayev, Lars Galldin, Mario Chiarello, Angela Lumba & Piotr J. Gorecki

Authors
  1. Vadim Nakhamiyayev
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lars Galldin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mario Chiarello
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Angela Lumba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Piotr J. Gorecki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Piotr J. Gorecki.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nakhamiyayev, V., Galldin, L., Chiarello, M. et al. Laparoscopic appendectomy is the preferred approach for appendicitis: a retrospective review of two practice patterns. Surg Endosc 24, 859–864 (2010). https://doi.org/10.1007/s00464-009-0678-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-009-0678-x

Keywords

Search

Navigation