Abstract
BackgroundOpen appendectomy (OA) has traditionally been the treatment for acute appendicitis (AA). Beneficial effects of laparoscopic appendectomy (LA) for the treatment of AA are still controversial.AimTo present our technique for LA and to determine whether LA should be the technique of choice of any case of AA instead of OA.Material and methodsAll cases operated for AA (February 2011 through February 2012) by means of LA or OA were prospectively evaluated. Data regarding length of stay, complications, emergency department consultation after discharge or readmission were collected. Patients were classified into four groups depending on the severity of the appendicitis. Economic data were obtained based on the cost of the disposable material. Cost of hospital stay was calculated based on the Ley de Tasas of the Generalitat Valenciana according to the DRG and the length of stay.ResultsOne hundred and forty-two cases were included. Ninety-nine patients underwent OA and 43 LA. Average length of stay for LA group was 2,6 days and 3,8 for OA. Average cost of the stay for OA was 1.799 euros and 1.081 euros for LA. Global morbidity rate was 16%, 5% for LA and 20% for OA.ConclusionsLA is nowadays the technique of choice for the treatment of AA.
Highlights
Acute appendicitis (AA) is the most frequent cause of acute abdominal pain in western countries, marked with an incidence of 100/100.000 cases per year [1] and the risk of having acute appendicitis (AA) is around 8% [1,2,3] in a lifetime
Due to the development of endoscopic surgery, Semm introduced the laparoscopic appendectomy (LA) in 1981 [2], rendering a minimally invasive procedure for the skin and abdomen [2,5]; many studies published in the very early years of the 21st century, comparing Open appendectomy (OA) and LA, didn’t really determine a superiority of the laparoscopic approach [6,7,8,9], some more recent papers, substantiate that LA is the technique of choice in the treatment of AA in terms of clinical advantage and cost
The aim of our study is to present our LA technique and determine if LA should be the technique of choice in any case of AA because of its lower cost, shorter hospital stay and lower morbidity, even though in principle it may seem to be a more expensive technique than OA due to the need for high cost disposable laparoscopic instruments
Summary
Acute appendicitis (AA) is the most frequent cause of acute abdominal pain in western countries, marked with an incidence of 100/100.000 cases per year [1] and the risk of having AA is around 8% [1,2,3] in a lifetime. The current floundering economy of Spain (and many other European Countries) is seriously affecting health services. It is, our duty to achieve optimal efficiency in the surgical procedures we perform with the aim of doing the best for our patients at a minimal cost. The aim of our study is to present our LA technique and determine if LA should be the technique of choice in any case of AA because of its lower cost, shorter hospital stay and lower morbidity (higher cost-effectiveness), even though in principle it may seem to be a more expensive technique than OA due to the need for high cost disposable laparoscopic instruments. Beneficial effects of laparoscopic appendectomy (LA) for the treatment of AA are still controversial
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