medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2019, Number 1

<< Back Next >>

Cir Gen 2019; 41 (1)

Acute appendicitis: laparoscopic approach versus open surgery; costs and complications

Magaña-Mainero P, De-Luna-Gallardo D, Picazo-Ferrera K, Sainz-Hernández JC, Ortiz de la Peña-Rodríguez JA

Language: Spanish
References: 36
Page: 6-11
PDF size: 174.27 Kb.


ABSTRACT

Introduction: Acute appendicitis represents one of the most common surgical emergencies during daily surgical practice. The decision to perform open versus laparoscopic surgery continues to depend on the resources and training of the surgeon. Objective: The general objective of this study is to compare the surgical treatment of acute appendicitis, both laparoscopic and open, in a series of cases, analyzing the most common complications and costs generated for the patient. Material and methods: We conducted an observational, retrospective study with all cases operated for acute appendicitis in a period of 23 months. We performed an analysis taking as variables the demographics, transoperative findings, days of in-hospital stay or any postoperative complications. Results: With a total population of 713 patients, laparoscopic appendectomy was performed on 647 (90.74%) and appendectomy by open approach on 66; eight (1.24%) and four (6.06%) patients, respectively, presented postoperative complications during their treatment, which generated a considerable increase in costs, as well as in the average days of in-hospital stay. Conclusions: Laparoscopic management of acute appendicitis offers benefits such as a shorter hospital stay and a lower percentage of complications. Unlike open surgery, residual abscesses postoperative to laparoscopic surgery did not require reoperation, and there were no cases with wound dehiscence. Although laparoscopic surgery is more expensive on average, it offers less serious complications and its costs, when compared to those generated by open surgery, are lower.


REFERENCES

  1. Ingraham AM, Cohen ME, Bilimoria K, Pritts TA, Ko CY, Esposito TJ. Comparison of outcomes after laparoscopic versus open appendectomy for acute appendicitis at 222 ACS NSQIP hospitals. Surgery. 2010; 148: 625-635.

  2. Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston textbook of surgery. 18th edition. Philadelphia: Ed. Elsevier; 2007. pp. 1333-1347.

  3. Sanabria A, Domínguez LC, Bermúdez C, Serna A. Evaluación de escalas diagnósticas en pacientes con dolor abdominal sugestivo de apendicitis. Biomédica. 2007; 27: 419-428.

  4. Bennett J, Boddy A, Rhodes M. Choice of approach for appendicectomy: a meta-analysis of open versus laparoscopic appendicectomy. Surg Laparosc Endosc Percutan Tech. 2007; 17: 245-255.

  5. McBurney C. The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg. 1894; 20: 38-43.

  6. Semm K. Endoscopic appendectomy. Endoscopy. 1983; 15: 59-64.

  7. Krisher SL, Browne A, Dibbins A, Tkacz N, Curci M. Intra-abdominal abscess after laparoscopic appendectomy for perforated appendicitis. Arch Surg. 2001; 136: 438-441.

  8. Frazee RC, Bohannon WT. Laparoscopic appendectomy for complicated appendicitis. Arch Surg. 1996; 131: 509-511.

  9. Bonanni F, Reed J, Hartzell G, Trostle D, Boorse R, Gittleman M, et al. Laparoscopic versus conventional appendectomy. J Am Coll Surg. 1994; 179: 273-278.

  10. Frazee RC, Roberts JW, Symmonds RE, Snyder SK, Hendricks JC, Smith RW, et al. A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg. 1994; 219: 725-728.

  11. Guller U, Hervey S, Purves H, Muhlbaier LH, Peterson ED, Eubanks S, et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg. 2004; 239: 43-52.

  12. Ortega AE, Hunter JG, Peters JH, Swanstrom LL, Schirmer B. A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic Appendectomy Study Group. Am J Surg. 1995; 169: 208-212.

  13. Hellberg A, Rudberg C, Kullman E, Enochsson L, Fenyo G, Graner H, et al. Prospective randomized multicentre study of laparoscopic versus open appendectomy. Br J Surg. 1999; 86: 48-53.

  14. Fukami Y, Hasegawa H, Sakamoto E, Komatsu S, Hiromatsu T. Value of laparoscopic appendectomy in perforated appendicitis. World J Surg. 2007; 31: 93-97.

  15. Katsuno G, Nagakari K, Yoshikawa S, Sugiyama K, Fukunaga M. Laparoscopic appendectomy for complicated appendicitis: a comparison with open appendectomy. World J Surg. 2009; 33: 208-214.

  16. Kirshtein B, Bayme M, Domchik S, Mizrahi S, Lantsberg L. Complicated appendicitis: laparoscopic or conventional surgery? World J Surg. 2007; 31: 744-749.

  17. Di Saverio S, Mandrioli M, Sibilio A, Smerieri N, Lombardi R, Catena F, et al. A cost-effective technique for laparoscopic appendectomy: outcomes and costs of a case–control prospective single-operator study of 112 unselected consecutive cases of complicated acute appendicitis. J Am Coll Surg. 2014; 218: e51-e65.

  18. Cardenas-Salomon CM, Cervantes-Castro J, Jean-Silver ER, Toledo-Valdovinos SA, Murillo A, Posada-Torres JA. Costos de hospitalización por apendicectomía abierta comparados con los de laparoscópica. Experiencia de cinco años. Cir Cir. 2011; 79: 534-539.

  19. Gomes CA, Sartelli M, Di Saverio S, Ansaloni L, Catena F, Coccolini F, et al. Acute appendicitis: proposal of a new comprehensive grading system based on clinical, imaging and laparoscopic findings. World J Emerg Surg. 2015; 10: 60.

  20. González-Aguilera JC. Pronóstico de la peritonitis generalizada según el índice de Mannheim. Cir Cir. 2002; 70: 179-182.

  21. Fogli L, Brulatti M, Boschi S, Di Domenico M, Papa V, Patrizi P, et al. Laparoscopic appendectomy for acute and recurrent appendicitis: retrospective analysis of a single-group 5-year experience. J Laparoendosc Adv Surg Tech A. 2002; 12: 107-110.

  22. Garbutt JM, Soper NJ, Shannon W, Botero A, Littenberg B. Meta-analysis of randomized controlled trials comparing laparoscopic and open appendectomy. Surg Laparosc Endosc. 1999; 9: 17-26.

  23. Towfigh S, Chen F, Mason R, Katkhouda N, Chan L, Berne T. Laparoscopic appendectomy significantly reduces length of stay for perforated appendicitis. Surg Endosc. 2006; 20: 495-499.

  24. Shaikh AR, Sangrasi AK, Shaikh GA. Clinical outcomes of laparoscopic versus open Appendectomy. JSLS. 2009; 13: 574-580.

  25. Olmi S, Magnone S, Bertolini A, Croce E. Laparoscopic versus open appendectomy in acute appendicitis: a randomized prospective study. Surg Endosc. 2005; 19: 1193-1195.

  26. Ignacio RC, Burke R, Spencer D, Bissell C, Dorsainvil C, Lucha PA. Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc. 2004; 18: 334-337.

  27. Kurtz RJ, Heimann TM. Comparison of open and laparoscopic treatment of acute appendicitis. Am J Surg. 2001; 182: 211-214.

  28. Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R. Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg. 2005; 242: 439-448.

  29. Kehagias I, Karamanakos SN, Panagiotopoulos S, Panagopoulos K, Kalfarentzos F. Laparoscopic versus open appendectomy: which way to go ? World J Gastroenterol. 2008; 14: 4909-4914.

  30. Fingerhut A, Millat B, Borrie F. Laparoscopic versus open appendectomy: time to decide. World J Surg. 1999; 23: 835-845.

  31. Chu T, Chandoke R, Smith P. The impact of surgeon choice on the cost performing laparoscopic appendectomy. Surg Endosc. 2011; 25: 1187-1191.

  32. Partecke LI, Bernstoff W, Karrasch A. Unexpected findings on laparoscopy for suspected acute appendicitis: a pro for laparoscopic appendectomy as the standard procedure for acute appendicitis. Langenbecks Arch Surg. 2010; 395: 1069-1076.

  33. Hass L, Stargardt T, Schreyoegg J. Cost-effectiveness of open versus laparoscopic appendectomy: a multilevel approach with propensity score matching. Eur J Health Econ. 2012; 13: 549-560.

  34. Jaschinski T, Mosch C, Eikermann M, Neugebauer EA. Laparoscopic versus open appendectomy in patients with suspected appendicitis: a systematic review of meta-analyses of randomised controlled trials. BMC Gastroenterol. 2015; 15: 48.

  35. Dai L, Shuai J. Laparoscopic versus open appendectomy in adults and children: A meta-analysis of randomized controlled trials. United European Gastroenterol J. 2017; 5: 542-553.

  36. Ali SM, Hassanain M. Laparoscopic versus open appendectomy. Saudi J Gastroenterol. 2011; 17: 225-226.




2020     |     www.medigraphic.com