Skip to main content
Log in

Laparoscopic versus open appendicectomy: A comparative study

  • Randomized Control Trial
  • Published:
Hellenic Journal of Surgery

Abstract

Acute appendicitis is one of the most common emergency surgical problems encountered. Pioneered by McBurney in 1894, appendicectomy is considered the treatment of choice for acute appendicitis. Since its initial description by Semm in 1983, Laparoscopic appendicectomy (LA) has struggled to prove its superiority over the open technique. The advantages of LA over open appendicectomy (OA) are believed to be less postoperative pain, shorter hospital stay and early return to usual activity, while the incidence of postoperative wound infection is also thought to be lower. However, certain views contend that the benefit of this method is minimal, with higher cost. Though multiple prospective randomized trials, meta-analyses, and systematic reviews have been conducted to assess the value of LA over OA, the heterogeneity of the measured variables and other weaknesses in methodology have not allowed definitive conclusions to be drawn. In our study, we also took into consideration the above parameters so as to compare the advantage of LA versus OA but found no statistical significance of LA over OA.

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

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

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. Samelson SL, Reyes HM. Management of perforated appendicitis in children-revisited. Arch Surg 1987; 122:691–6

    Article  CAS  PubMed  Google Scholar 

  2. Editorial. A sound approach to the diagnosis of acute appendicitis. Lancet 1987; i:198–200

    Google Scholar 

  3. Majeed AW, Troy G, Nicholl JP, et al. Randomized, prospective, single-blind comparison of laparoscopic versus small-incision cholecystectomy. Lancet 1996; 347:989–94

    Article  CAS  PubMed  Google Scholar 

  4. Michael JZ, Stanley WA, Douglas SS, et al. Appendix and appendectomy. Maingot’s abdominal operations. 11th edition. 2007; 21:589–608

    Google Scholar 

  5. Frazee RC, Roberts JW, Symmonds RE, et al. A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg 1994; 219:725–8

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Chung RS, Rowland DY, Li P, et al. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg 1999; 177:250–6

    Article  CAS  PubMed  Google Scholar 

  7. Garbutt JM, Soper NJ, Shannon WD, et al. Meta-analysis of randomized controlled trials comparing laparoscopic and open appendectomy. Surg Laparosc Endosc 1999; 9:17–26

    Article  CAS  PubMed  Google Scholar 

  8. Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a meta-analysis. J Am Coll Surg 1998; 186:545–53

    Article  CAS  PubMed  Google Scholar 

  9. Sauerland S, Lefering R, Holthausen U, et al. Laparoscopic vs conventional appendectomy: a meta-analysis of randomized controlled trials. Arch Surg 1998; 383:289–95

    Article  CAS  Google Scholar 

  10. Fingerhut A, Millat B, Borrie F. Laparoscopic versus open appendectomy: time to decide. World J Surg 1999; 23:835–45

    Article  CAS  PubMed  Google Scholar 

  11. McCall JL, Sharples K, Jadallah F. Systematic review of randomized controlled trials comparing laparoscopic with open appendicectomy. Br J Surg 1997; 84:1045–50

    Article  CAS  PubMed  Google Scholar 

  12. Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2002;(1):CD001546

    Google Scholar 

  13. Slim K, Pezet D, Chipponi J. Laparoscopic or open appendectomy? critical review of randomized, controlled trials. Dis Colon Rectum 1998; 41:398–403

    Article  CAS  PubMed  Google Scholar 

  14. Tate JJ, Dawson JW, Chung SC, et al. Laparoscopic versus open appendicectomy: prospective randomised trial. Lancet 1993; 342:633–7

    Article  CAS  PubMed  Google Scholar 

  15. Ortega AE, Hunter JG, Peters JH, et al. A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Am J Surg 1995; 169:208–12

    Article  CAS  PubMed  Google Scholar 

  16. Minne L, Varner D, Burnell A, et al. Laparoscopic vs. open appendectomy: prospective randomized study of outcomes. Arch Surg 1997; 132:708–11

    CAS  PubMed  Google Scholar 

  17. Katkhouda N, Rodney JM, Shirin T, et al. Laparoscopic versus open appendectomy: A prospective randomized double-blind study. Ann Surg 2005; 242:439–50

    PubMed Central  PubMed  Google Scholar 

  18. Guller U, Hervey S, Purves H, et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg 2004; 239:43–52

    Article  PubMed Central  PubMed  Google Scholar 

  19. Heikkinen TJ, Haukipuro K, Hulkko A. Cost-effective appendectomy. Open or laparoscopic? A prospective randomized study. Surg Endosc 1998; 12:1204–8

    CAS  PubMed  Google Scholar 

  20. Pedersen AG, Petersen OB, Wara P, et al. Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg 2001; 88:200–5

    Article  CAS  PubMed  Google Scholar 

  21. Klingler A, Henle KP, Beller S, et al. Laparoscopic appendectomy does not change the incidence of postoperative infectious complications. Am J Surg 1998; 175:232–5

    Article  CAS  PubMed  Google Scholar 

  22. Katkhouda N, Friedlander MH, Grant SW, et al. Intraabdominal abscess rate after laparoscopic appendectomy. Am J Surg 2000; 180:456–9

    Article  CAS  PubMed  Google Scholar 

  23. Ignacio RC, Burke R, Spencer D, et al. Laparoscopic versus open appendectomy: what is the real difference? results of a prospective randomized double-blinded trial. SurgEndosc 2004; 18:334–7

    CAS  Google Scholar 

  24. Temple LK, Litwin DE, McLeod RS. A meta-analysis of laparoscopic versus open appendectomy in patients suspected of having acute appendicitis. Can J Surg 1999; 42:377–83

    PubMed Central  CAS  PubMed  Google Scholar 

  25. Vallina VL, Velasco JM, McCulloch CS. Laparoscopic versus conventional appendectomy. Ann Surg 1993; 218:685–92.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Richards KF, Fisher KS, Flores JH, et al. Laparoscopic appendectomy: comparison with open appendectomy in 720 patients. Surg Laparosc Endosc 1996; 6:205–9

    Article  CAS  PubMed  Google Scholar 

  27. Heinzelmann M, Simmen HP, Cummins AS, et al. Is laparoscopic appendectomy the new ‘gold standard’? Arch Surg 1995; 130:782–5

    Article  CAS  PubMed  Google Scholar 

  28. Kurtz RJ, Heimann TM. Comparison of open and laparoscopic treatment of acute appendicitis. Am J Surg 2001; 182:211–4

    Article  CAS  PubMed  Google Scholar 

  29. Moberg AC, Montgomery A. Appendicitis: laparoscopic versus conventional operation: a study and review of literature. Surg Laparosc Endosc 1997; 7:459–63

    Article  CAS  PubMed  Google Scholar 

  30. Fallahzadeh H. Should a laparoscopic appendectomy be done? Am Surg 1998; 64:231–3

    CAS  PubMed  Google Scholar 

  31. Hebebrand D, Troidl H, Spangenberger W, et al. Laparoscopic or classical appendectomy? A prospective randomized study. Chirurg 1994; 65:112–20

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Abidali Karat Parambil.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abbas, S.K., Mannarakkal, R., Parambil, A.K. et al. Laparoscopic versus open appendicectomy: A comparative study. Hellenic J Surg 88, 18–24 (2016). https://doi.org/10.1007/s13126-016-0277-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13126-016-0277-y

Keywords

Navigation