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Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial

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Abstract

Background

The advantages of laparoscopic appendectomy did not meet the same acceptance in the setting of perforated appendicitis as in uncomplicated appendicitis in the general surgical community. The aim of this study was to compare the clinical outcome of laparoscopic and open appendectomy in perforating appendicitis.

Methods

A randomized controlled study was conducted on 126 patients presenting with perforated appendicitis. Sixty patients were subjected to laparoscopic appendectomy (LA) and 66 patients underwent traditional open appendectomy (OA).

Results

65 (51.6%) patients were female, and 61 (48.4%) patients were male in whom the mean age was 37.6 + 8.5 years. A significant difference was calculated in the domains of postoperative pain, less need for analgesics, hospital stay, and return to daily activities. The mean operative time was shorter in OA 94 ± 10.4 min than LA 120.6 ± 17.7 min. No statistically significant difference between both groups was detected as regard occurrence of intra-abdominal collection.

Conclusion

In view of its clinical outcomes, laparoscopy should be considered in the context of perforated appendicitis. The possibility of intra-abdominal collection should not be a barrier against the widespread practice of this surgical procedure amidst laparoscopic surgeons if adequate precautions are employed.

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Authors and Affiliations

  1. Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, 21561, Egypt

    Ahmed Talha & Gihan Shehata

  2. Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Hany El-Haddad & Abd-Elhamid Ghazal

  3. Petroleum Hospital, Alexandria, Egypt

    Ahmed Talha & Hany El-Haddad

  4. Mabaret Alasafra Hospitals, Alexandria, Egypt

    Ahmed Talha, Hany El-Haddad & Abd-Elhamid Ghazal

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  1. Ahmed Talha
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  2. Hany El-Haddad
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  4. Gihan Shehata
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Correspondence to Ahmed Talha.

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Ahmed Talha, Hany El-Haddad, Abd-Elhamid Ghazal and Gihan Shehata have no conflict of interest or financial ties to disclose.

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Talha, A., El-Haddad, H., Ghazal, AE. et al. Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial. Surg Endosc 34, 907–914 (2020). https://doi.org/10.1007/s00464-019-06847-2

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  • DOI: https://doi.org/10.1007/s00464-019-06847-2

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