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2012, Number 4

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Rev Mex Cir Endoscop 2012; 13 (4)

Residual abscess in complicated acute appendicitis in laparoscopic management versus conventional open surgery

Morales VJM, Crisanto BA, Torres MF, Bada O, Rojano ME, Mucio M

Language: Spanish
References: 58
Page: 195-200
PDF size: 177.28 Kb.


ABSTRACT

At the beginning of the appendectomy laparoscopic surgery, it showed more residual abscesses that the conventional surgery. Nevertheless, in the last five years worldwide papers report a reduction in the frequency of residual abscesses; even less than open surgery. Objective: To compare the residual abscesses frequency in appendectomy laparoscopic versus open surgery in patients admitted with complicated appendicitis acute (necrosis, perforation or peritonitis). Material and methods: A prospective, comparative, randomized and experimental study. We included all patients older than 18 years old with complicated appendicitis admitted to surgery in the general hospital «Dr. Manuel Gea González», from May 1st, 2011 to April 30th, 2012. We excluded patients with incomplete file, without follow up, with converted technique or with contraindications to laparoscopic surgery. Results: Of 190 patients, 101 (53-15%) patients were operated with conventional surgery and 89 (46.84%) with laparoscopic technique. In both groups, the demographic characteristics were similar. In the open group (101 patients), 33 (32.67%) were women and 68 (67.32%) were men. The average age was 33.6 years old (18 to 75). The evolution time of the appendicitis was 57.6 hours (8-360 hours). The average surgical time was 70 minutes (25-130 minutes). 55 patients had a drain tube. The hospital length of stay was 3.3 days. In the laparoscopic group, 39 patients (43.8%) were women and 50 (56.17%) men. The average age was 35.1 years old (18 to 74). The evolution time of the appendicitis was 44.6 hours (7-360 hours). The average surgical time was 76 minutes (35-150 minutes). 34 patients had a drain tube. The hospital length of stay was 2.61 days In the laparoscopic group, only one case of residual abscess showed up (1.12%), versus four cases (3.96%) in the open group, with a no significance difference (p = 0.62). Conclusion: Both groups showed up similar results but with a tendency of best results and less frequency of residual abscess with the laparoscopic technique. Besides the proved benefits of the laparoscopic surgery, we show security and the tendency of best results with this technique.


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