Surgical Endoscopy

, Volume 24, Issue 2, pp 266–269 | Cite as

Laparoscopic versus open appendectomy: a prospective randomized comparison

  • Hong-Bo WeiEmail author
  • Jiang-Long Huang
  • Zong-Heng Zheng
  • Bo Wei
  • Feng Zheng
  • Wan-Shou Qiu
  • Wei-Ping Guo
  • Tu-Feng Chen
  • Tian-Bao Wang



Whether laparoscopy offers a benefit over open surgery in the management of acute appendicitis or not remains a subject of controversy despite the publication of numerous randomized studies. This study aimed to compare laparoscopic appendectomy (LA) with open appendectomy (OA) and to ascertain its therapeutic benefit.


Adult patients older than 14 years presenting with signs and symptoms suggestive of acute appendicitis were randomized to undergo either LA or OA from January 2006 to December 2007. Comparisons were based on operating time, time until return to a general diet, time until return to normal activity and work, length of hospital stay, billed charges, and postoperative complications.


The study enrolled 220 patients: 108 to undergo OA and 112 to undergo LA. The groups were similar in terms of clinicopathologic characteristics. The operating time seemed to be shorter for the OA patients than for the LA patients, but the difference was not significant (LA, 30 ± 15.2 min vs. OA, 28.7 ± 16.3 min; p > 0.05). The hospital stay of 4.1 ± 1.5 days for the LA group and 7.2 ± 1.7 days for the OA group, and the difference was statistically significant (p < 0.05). Laparoscopic appendectomy remained associated with a shorter time until return to a general diet (LA, 20.2 ± 12.4 h vs. OA, 36.5 ± 10 h; p < 0.05), to normal activity (LA, 9.1 ± 4.2 days vs. OA, 13.7 ± 5.8 days; p < 0.05), and to work (LA, 21.2 ± 3.5 days vs. OA, 27.7 ± 4.9 days; p < 0.05). The billed charges appeared to be higher for LA (LA, 5,720.3 ± 115.7 yuan vs. OA, 5,310 ± 575.4 yuan), but this difference failed to be clinically important or statistically significant (p > 0.05). Wound infections were more common after OA (n = 14) than after LA (n = 0) (p < 0.05). Intraabdominal abscesses occurred for two patients in the LA group and nine patients in the OA group (p < 0.05). Postoperative ileus occurred with frequencies of 0% in the LA group and 7.4% in the OA group (p < 0.05). The rate for overall complications was significantly lower in the LA group.


Laparoscopic appendectomy is a useful tool in the treatment of acute appendicitis. Its advantages lie in its minimal invasiveness, its better cosmetic outcome, its lower rate of complications based on surgical expertise and state-of-the-art equipment. It can be recommended as an adoptable method for the routine patient with appendicitis.


Appendectomy Laparoscopic Open 



The work was supported by the Science and Technology Planning Project of Guangzhou (no. 2007Z3-E0661).


  1. 1.
    Semm K (1983) Endoscopic appendectomy. Endoscopy 15:59–64CrossRefPubMedGoogle Scholar
  2. 2.
    Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R (2005) Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg 242:439–450Google Scholar
  3. 3.
    Merhoff AM, Merhoff GC, Franklin ME (2000) Laparoscopic versus open appendectomy. Am J Surg 179:375–378CrossRefPubMedGoogle Scholar
  4. 4.
    Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R (2005) Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg 242:439–448PubMedGoogle Scholar
  5. 5.
    Helmy MA (2001) A comparative study between laparoscopic versus open appendicectomy in men. J Egypt Soc Parasitol 31:555–562PubMedGoogle Scholar
  6. 6.
    Pedersen AG, Petersen OB, Wara P, Ronning H, Qvist N, Laurberg S (2001) Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg 88:200–205CrossRefPubMedGoogle Scholar
  7. 7.
    Neugebauer E, Troidl H, Kum CK, Eypasch E, Miserez M, Paul A (1995) The E.A.E.S. consensus development conferences on laparoscopic cholecystectomy, appendectomy, and hernia repair: consensus statements—September 1994. Surg Endosc 9:550–563PubMedGoogle Scholar
  8. 8.
    So JB, Chiong EC, Chiong E, Cheah WK, Lomanto D, Goh P, Kum CK (2002) Laparoscopic appendectomy for perforated appendicitis. World J Surg 26:1485–1488CrossRefPubMedGoogle Scholar
  9. 9.
    Long KH, Bannon MP, Zietlow SP, Helgeson ER, Harmsen WS, Smith CD, Ilstrup DM, Baerga-Varela Y, Sarr MG, Laparoscopic Appendectomy Interest Group (2001) A prospective randomized comparison of laparoscopic appendectomy with open appendectomy: clinical and economic analyses. Surgery 129:390–400PubMedGoogle Scholar
  10. 10.
    Lavonius MI, Liesjarvi S, Ovaska J, Pajulo O, Ristkari S, Alanen M (2001) Laparoscopic versus open appendectomy in children: a prospective randomised study. Eur J Pediatr Surg 11:235–238CrossRefPubMedGoogle Scholar
  11. 11.
    Paya K, Fakhari M, Rauhofer U (2000) Open versus laparoscopic appendectomy in children: a comparison of complications. J Soc Laparoendosc Surg 4:121–124Google Scholar
  12. 12.
    Vernon AH, Georgeson KE, Harmon CM (2004) Pediatric laparoscopic appendectomy for acute appendicitis. Surg Endosc 18:75–79CrossRefPubMedGoogle Scholar
  13. 13.
    Koontz CS, Smith LA, Burkholder HC, Higdon K, Aderhold R, Carr M (2006) Video-assisted transumbilical appendectomy in children. J Pediatr Surg 4:710–712CrossRefGoogle Scholar
  14. 14.
    Lintula H, Kokki H, Vanamo K (2001) Single blind randomized clinical trial of laparoscopic versus open appendicectomy in children. Br J Surg 88:510–514CrossRefPubMedGoogle Scholar
  15. 15.
    Meguerditchian AN, Prasil P, Cloutier R, Leclerc S, Peloquin J, Roy G (2002) Laparoscopic appendectomy in children: a favorable alternative in simple and complicated appendicitis. J Pediatr Surg 37:695–698CrossRefPubMedGoogle Scholar
  16. 16.
    Peiser JG, Greenberg D (2002) Laparoscopic versus open appendectomy: results of a retrospective comparison in an Israeli hospital. Isr Med Assoc J 4:91–94PubMedGoogle Scholar
  17. 17.
    Bennett J, Boddy A, Rhodes M (2007) Choice of approach for appendicectomy: a meta-analysis of open versus laparoscopic appendicectomy. Surg Laparosc Endosc Percutan Tech 17:245–255CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Hong-Bo Wei
    • 1
    Email author
  • Jiang-Long Huang
    • 1
  • Zong-Heng Zheng
    • 1
  • Bo Wei
    • 1
  • Feng Zheng
    • 1
  • Wan-Shou Qiu
    • 1
  • Wei-Ping Guo
    • 1
  • Tu-Feng Chen
    • 1
  • Tian-Bao Wang
    • 1
  1. 1.Department of Gastrointestinal SurgeryThe Third Affiliated Hospital of Sun Yat-Sen UniversityGuangZhouChina

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