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Laparoscopic appendectomy

A comparison with open appendectomy


PURPOSE: As laparoscopy becomes a greater part of a general surgeon's practice, each new application must be analyzed. The purpose of this article is to report a four-year experience with laparoscopic appendectomy, with special attention to complications. METHODS: All patients undergoing appendectomy by members of the General Surgery Department of Columbia Hospital between December 20, 1990, and December 24, 1994, were included (n=434). Medical records were reviewed, and data were analyzed using multiple regression analysis, analysis of variance, and Pearson's chi-squared test. RESULTS: The number of postoperative intra-abdominal abscesses following laparoscopic appendectomy tended to be higher; however, this did not reach statistical significance. Conversely, all other complications combined demonstrated a rate of 4.3 percent for laparoscopic procedures and a rate of 8.5 percent for open procedures. Again this tended toward, but did not reach, statistical significance. Advantage in length of stay was approximately two days, with a mean length of stay for patients undergoing laparoscopic appendectomy of 3.3 days, whereas that for open appendectomy was 5.7 days. CONCLUSION: Laparoscopic appendectomy has significant advantages in terms of patient comfort and length of stay, and its overall complication rate seems to be lower than with open procedures; however, its rate of intra-abdominal abscess may actually be higher. Further study is recommended.

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Kluiber, R.M., Hartsman, B. Laparoscopic appendectomy. Dis Colon Rectum 39, 1008–1011 (1996).

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Key words

  • Laparoscopic
  • Appendectomy
  • Abscess
  • Complications