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Safety and feasibility of laparoscopic surgery for appendiceal mucocele: a multicenter study

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Abstract

Background

Although laparoscopic appendectomy has been widely performed since 1987, concerns over potential spillage of mucus into the peritoneal cavity during laparoscopic manipulation have prevented the use of laparoscopic surgery (LS) for appendiceal mucocele. The purpose of the present study was to evaluate the safety, feasibility, and short-term perioperative outcomes of LS for appendiceal mucocele.

Methods

A retrospective review was performed to identify patients diagnosed with appendiceal mucocele based on their imaging studies and who underwent surgery at one of six Hallym-University-affiliated hospitals between January 2007 and June 2016. Patient demographics, surgical outcomes, and postoperative outcomes were retrospectively analyzed.

Results

A total of 96 patients were evaluated, of whom 58 underwent LS (LS group) and 38 underwent open surgery (OS; OS group). There were no significant differences in patient characteristics between groups. The operation time was similar in both groups (P = 0.399). Intraoperative rupture occurred in two patients in each group (no significant difference, P = 0.647). Time to flatus, time to soft food intake, and length of hospital stay were shorter in the LS group than in the OS group (2.4 vs. 3.2 days, P = 0.003; 3.6 vs. 4.5 days, P = 0.024; 6.5 vs. 8.8 days, P = 0.011, respectively). The rate of postoperative complications was similar between the groups (P = 0.786). Univariate analysis revealed that rupture of appendiceal mucocele was associated with white blood cell count > 10,000/µL (P = 0.032) but not with LS (P = 0.647).

Conclusions

The results showed that LS is safe and feasible for the surgical treatment of appendiceal mucocele. An elevated WBC count was associated with a risk of appendiceal mucocele rupture.

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Acknowledgements

This research was supported by Hallym University Research Fund 2017 (HURF-2017-28).

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Authors and Affiliations

  1. Department of Surgery, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 40, Sukwoo-Dong, Hwaseong-Si, 445-170, Gyeonggi-Do, Republic of Korea

    Tae Kyu Kim, Jeong Yeon Kim & Jong Wan Kim

  2. Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, 445 Gil-1-dong, Gangdong-gu, Seoul, 134-701, Republic of Korea

    Jun Ho Park

  3. Department of Surgery, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 948-1, Daerim-1 Dong, Yeongdeungpo-gu, Seoul, 150-950, Republic of Korea

    Byung Chun Kim

  4. Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon Si, Republic of Korea

    Byung Mo Kang

  5. Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang Si, Republic of Korea

    Soo Kee Min

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  1. Tae Kyu Kim
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Correspondence to Jong Wan Kim.

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Tae Kyu Kim, Jun Ho Park, Jeong Yeon Kim, Byung Chun Kim, Byung Mo Kang, and Soo Kee Min have no conflicts of interests. Jong Wan Kim was supported by Hallym University Research Fund 2017 (HURF-2017-28).

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Kim, T.K., Park, J.H., Kim, J.Y. et al. Safety and feasibility of laparoscopic surgery for appendiceal mucocele: a multicenter study. Surg Endosc 32, 4408–4414 (2018). https://doi.org/10.1007/s00464-018-6182-4

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  • DOI: https://doi.org/10.1007/s00464-018-6182-4

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