ХИРУРГИЧЕСКОЕ ЛЕЧЕНИЕ ОСТРОГО АППЕНДИЦИТА: ЛАПАРОСКОПИЧЕСКАЯ ИЛИ ОТКРЫТАЯ АППЕНДЭКТОМИЯ?

Abstract

The results of laparoscopic and "traditional" open appendectomy for acute appendicitis were studied, and postoperative complications were analyzed. The retrospective analysis of surgical treatment of 518 patients with acute appendicitis was carried out. In 433 (83.6%) cases laparoscopic appendectomy was performed, in 84 (16.2%) – open appendectomy. In laparoscopic surgery the ligature method of appendectomy was used, in open surgery invagination method was used. Indications for drainage of the abdominal cavity during laparoscopic and open appendectomy did not fundamentally differ. According to the results of a morphological study phlegmonous appendicitis was observed in 463 (89.4%) cases, gangrenous – in 55 (10.6%). After open appendectomies complications were detected in 11 patients, the overall incidence of postoperative complications was 13.1%. After laparoscopic appendectomies complications were detected in 4 patients, the overall incidence of postoperative complications was 0.9%. The rate of postoperative complications after laparoscopic appendectomy was statistically significantly lower than after open appendectomy. The nature of complications in laparoscopic and open appendectomy differs. In open appendectomy infectious complications of the surgical wound are observed, which do not require surgical treatment. In laparoscopic appendectomy intra-abdominal complications are observed, which in some cases require repeated surgical interventions. During laparoscopic appendectomy, there were such complications as stump leaks with peritonitis and inflammatory infiltrates of the abdominal cavity.