Perioperative results of apendicectomy by open  and laparoscopic approaches

Gisela Margarita Vargas-Méndez; Gustavo Alain Flores-Rangel; Javier García-Álvarez; Pablo Miranda-Fraga

2018, Number 4

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Rev Mex Cir Endoscop 2018; 19 (4)

Perioperative results of apendicectomy by open and laparoscopic approaches

Vargas-Méndez GM, Flores-Rangel GA, García-Álvarez J, Miranda-Fraga P

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Language: Spanish
References: 12
Page: 155-159
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ABSTRACT

Introduction: In 1981 the first appendectomy by laparoscopy was performed and since then, the comparison with the open approach has not lost its validity. Despite the demonstrated benefits of the laparoscopic approach, appendectomy by this approach has not been consolidated as the standard approach. Material and methods: Retrospective cohort study with the objective of contrasting the incidence of morbidity, bleeding and hospital stay between open and laparoscopic appendectomy in a period of two years. Results: A total of 423 patients were included, of which 127 (29.9%) corresponded with a laparoscopic approach and 296 with open approach (70.1%). The transoperative bleeding was lower in the laparoscopic approach compared to the open approach (59.6 vs 31.6 mL, p = 0.0001). The overall incidence of complications was lower in the laparoscopic approach (6.2 vs 18.8%), as well as the hospital stay in patients with phase 1 (31.5 vs 46.9 hrs, p = 0.0007) phase 2 (47.4 vs 54.4 hrs, p = 0.007) and phase 3 (63.1 vs 121.6 hrs, p = 0.0001), although similar in patients with phase 4 (240 vs 291.6 hrs, p = 0.54). Conclusions: The laparoscopic approach seems to be a better alternative than the open one for the resolution of acute appendicitis in function of a shorter hospital stay, transoperative bleeding and complications in general.

REFERENCES

Begin GF. Apendicectomía laparoscópica. EMC. Técnicas quirúrgicas-Aparato digestivo. Elsevier. 2006: 40-505. doi: 10.1016/S1282-9129(06)46240-1.
Cuendis-Velázquez A, Bada-Yllán O, Trejo-Ávila M, Rosales-Castañeda E, Rodríguez-Parra A, Moreno-Ordaz A et al. Robotic-assisted Roux-en-Y hepaticojejunostomy after bile duct injury. Langenbecks Arch Surg. 2018; 403: 53-59.
Chousleb A, Shuchleib A, Shuchleib S. Apendicectomía abierta versus laparoscópica. Cirujano General. 2010; 32: 91-95.
Pera BM. Cirugía: fundamentos, indicaciones y opciones técnicas. Barcelona: Ediciones Científicas y Técnicas S.A. 1983. p. 681.
Guía de Práctica Clínica Apendicitis Aguda. Asociación Mexicana de Cirugía General A.C. 2014. https://amcg.org.mx/images/guiasclinicas/apendicitis.pdf
Concha JA, Cartes-Velásquez R, Delgado CM. Single-incision laparoscopic appendectomy versus conventional laparoscopy in adults. A systematic review. Acta Cir Bras. 2014; 29: 826-831.
Li X, Zhang J, Sang L, Zhang W, Chu Z, Li X, Liu Y. Laparoscopic versus conventional appendectomy-a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2010; 10: 129.
Wei B, Qi CL, Chen TF, Zheng ZH, Huang JL, Hu BG et al. Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis. Surg Endosc. 2011; 25: 1199-1208.
Southgate E, Vousden N, Karthikesalingam A, Markar S, Black S, Zaidi A. Laparoscopic vs open appendectomy in older patients. Arch Surg. 2012; 147: 558-562.
Ciarrocchi A, Amicucci G. Laparoscopic versus open appendectomy in obese patients: a meta-analysis of prospective and retrospective studies. J Minim Access Surg. 2014; 10: 4-9.
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.
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.