Clinical efficacy of laparoscopy in the treatment of acute appendicitis in the elderly

Abstract

Objective To compare the effect of laparoscopy and laparotomy in the treatment of elderly patients (over 60 years) and young patients (18-60 years) with acute appendicitis, and to provide clinical basis for laparoscopic treatment of acute appendicitis in the elderly. Methods One hundred and sixty elderly patients with acute appendicitis in the Second Affiliated Hospital of Kunming Medical University from January 2015 to January 2017 were selected. Among them, 80 cases (elderly laparoscopic group) were treated by laparoscopy, 80 cases were treated by laparotomy (elderly laparotomy group), and 80 cases of young and middle-aged patients with acute appendicitis in the same period were selected as the control group. The clinical efficacy of three groups was compared. Results (1) There was statistically significant difference in discharge between the three groups (χ2=68.913, P<0.001). The elderly laparoscopic group was better than the elderly laparotomy group (Z=5.868, P<0.001), and the control group was better than the elderly laparoscopic group (Z=6.259, P<0.001). (2) The difference of postoperative complications among the three groups was statistically significant (χ2=10.800, P=0.005), with the highest [36.2% (29/80) ] in the elderly laparotomy group, and the lowest [13.8% (11/80)] in the control group. (3) The differences were statistically significant in hospitalization time, antibiotic use time, white blood cell level among the three groups (P<0.05). Compared to the elderly laparotomy group, postoperative exhaust time was significantly shorter in the other groups, the differences were statistically significant (P<0.05). The elderly patients had slow recovery after operation. Conclusions Compared with laparotomy, laparoscopic treatment has many advantages, such as quick recovery, less hospitalization time and fewer complications for elderly acute appendicitis, but shows delayed exhaustion and has higher complications than young and middle-aged patients. Laparoscopic treatment is recommended for elderly patients with acute appendicitis, while attention should be paid to promoting postoperative exhaustion and reducing complications. Key words: Appendicitis; Aged; Laparoscopes; Laparotomy