Comparison of complications of open and laparoscopic appendectomy

Özet

Introduction: Evaluations of laparoscopic appendectomy (LA) and open appendectomy (OA) as surgicaltreatment for acute appendicitis (AA) have yielded varying results. This assessment of the results observedat a single institution and some of the literature fidings is provided as a contribution to the discussion about the superiority of different techniques in different patient groups.Materials and Methods: The patient charts and electronic data of 1587 patients who underwent an OA or LA procedure between June 2014 and August 2018 were retrospectively reviewed. Patients younger than 18 years of age and patients with any pathology other than AA were excluded from the study. A total of 1423patients, 877 males (61.6%) and 546 females (38.4%), were included in the study. Patients who underwent OAwere classifid as Group I (n=771, 54.2%) and patients who underwent LA comprised Group II (n=652, 45.8%).Results: The mean age of the patients was 32.27±11.85 years, the mean duration of the operation was 59.77±20.24 minutes, the mean length of follow-up was 24.46±13.70 months, and the mean length of hospital stay was 1.61±1.14 days. The mean duration of the procedure was shorter in the OA group (58.8±20.9minutes) compared with the LA group (60.88±19.38 minutes) (p=0.002). The percentage of female patientswas higher in the LA group (42.94%) than in the OA group (34.50%) (p=0.001). The wound site infection ratewas higher in the OA group (9.9%) compared with the LA group (9.05%). The rate of complications requiringhospitalization was higher after OA (3.5%) compared with LA (2.3%), and the rate of complications requiring re-operation was also higher with OA (1.03%) compared with LA (0.3%). However, the difference in all parameters was statistically insignifiant.Conclusion: Both OA and LA are safe methods to treat AA. The rate of postoperative complications and the length of an OA operation have been decreasing progressively over the years; however, a preference for LA has been increasing over time. As for gallbladder operations, LA is likely to be the gold standard in AA treatment.