Cortez M, Burbano L, Cisneros A, Orbe M, Hinostroza I

Language: Spanish
References: 11
Page: 13-15
PDF size: 41.49 Kb.

ABSTRACT

The objective of this paper is to compare postoperative infection rate, between open appendectomy and laparoscopic appendectomy, classifying them according to microscopic appearance and pathology reports. Three groups were considered for this purpose: normal appendix, acute appendicitis, gangrenous and perforated appendicitis. Laparoscopic appendectomy in our study, decreased the incidence of postoperative infection, only in the third group. Material and methods: 854 patients where operated for appendicitis in our hospital between 1995 and 1999. Laparoscopic appendectomy (LA) was the procedure performed in 566 patients and open appendectomy (OA) was performed in 288 patients. Demographic data was similar in both groups. Written evaluation and telephone calls were the methods employed for follow up. Minimum follow up; 6 months. Postoperative infection was classified in two separate categories: intra-abdominal abscess and wound infection. Results: 85% of the patients treated were followed in two groups. Acute appendicitis was found in 52% of the patients in the LA group and fifty-four 54% of patient in the OA group (p = 0.633). Gangrenous and perforated appendicitis was found in 36% of the LA group and 37% in the OA group (p = 0.835). Postoperative infection in the OA group was 4.65%, (3.2% wound infection, 1.43% intra-abdominal abscess.) In the LA group postoperative infection was found in 2.29%, (1.94% wound infection, 0.35 intra-abdominal abscess.) If the severity of appendicitis is employed as a criteria for the gangrenous, perforated group. Post operative infection rate in LA increases to 3.22% (p = 0.01). Comments: Laparoscopic appendectomy and open appendectomy have similar incidence of postoperative infection in early uncomplicated disease, however we found a significant difference en those patients with severe disease or gangrenous perforated appendicitis.

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