Laparoscopic and open appendectomy in treatment of high-risk complicated appendicitis: a comparative study

Abstract

Objective To investigate the safety and feasibility of laparoscopic appendectomy (LA) in patients with high-risk complicated appendicitis. Methods The clinical data of 1 032 patients with complicated appendicitis, who were treated between June 2008 and June 2015, were analyzed retrospectively. Based on the American Association of Anesthesiologists (ASA) scoring criteria, 168 high-risk patients with ASA score of 3-4 were included. According to the surgical options, all patients were divided into the LA group (n=98) and open appendectomy group (OA group, n=70) . The preoperative preparation time, operation time, intraoperative blood loss, postoperative time to bowel movement, 24 h analgesic use, length of hospital stay and postoperative complications were compared between the two groups. Results The average preoperative preparation time in the LA group was longer than that in the OA group[ (20.2±4.1) min vs (15.5±3.2) min] (P 0.05) , whereas the postoperative time to bowel movement, 24 h analgesic use, and length of hospital stay were less or shorter than those in the OA group (P 0.05) . The incidences of lung, wound infection and abdominal abscess in the LA group were lower than those in the OA group (P<0.05) . There were no cases of stump fistula or operative deaths in both groups. Conclusion Laparoscopy is feasible in the treatment of high-risk complicated appendicitis with certain advantages. Key words: Appendicitis; Appendectomy; Laparoscopes