Tomoya Takami. Departments of Surgery, Kishiwada Tokushukai Hospital.
Background: Appendectomy is one of the most common operations performed during emergency surgery. Although laparoscopic appendectomy (LA) has become the treatment of choice, there is still a debate regarding the use of LA for treating complicated appendicitis. In this retrospective analysis, we aimed to clinically compare LA and open appendectomy (OA) for treating complicated appendicitis.
Methods: We retrospectively identified 339 patients who underwent an operation for complicated appendicitis at our hospital; these patients were operated on between 2011 and July 2017.[Editor1] In total, 222 patients underwent conventional appendectomy and 117 patients were laparoscopically treated. Outcomes included operation time, blood loss, length of hospital stay, and postoperative complications. Logistic regression analysis was performed to analyze the concurrent effects of various factors on the rate of postoperative complications.
Results:The mean ± standard deviation ages of the patients in the LA and OA groups were 46.98 ± 26.2 and 49.56 ± 22.4 years, respectively (P = 0.443). There were no significant differences in the operation time between the patients in the LA and OA groups (92.83 ± 39.5 vs. 90 ± 44.3[Editor2] ; P = 0.63). Length of hospital stay was shorter for the patients in the LA group than for those in the OA group (8.5 ± 4.64 vs. 12.67 ± 9.89; P = 0.0005). Return to soft diet was faster for the patients in the LA group than for those in the OA group (1.88 ± 1.59 vs. 2.48 ± 2.33; P = 0.04). Multivariable analysis found that the rate of postoperative complications was significantly reduced among the patients in the LA group than among those in the OA group (15.2% vs. 27.5%; odds ratio, 0.455; 95% confidence interval, 0.2–0.996; P = 0.048).
Conclusions: Our results demonstrated that LA is a safe and effective procedure with clinically beneficial advantages. Appendectomy for treating complicated appendicitis should be attempted first laparoscopically.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 85279
Program Number: P050
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster