Is laparoscopic appendectomy the new 'gold standard'?
M. Heinzelmann, H. P. Simmen, A. S. Cummins and F. Largiader
Department of Surgery, University of Zurich, Switzerland.
OBJECTIVES: To determine the efficacy of laparoscopic appendectomy compared
with open appendectomy in patients with acute appendicitis and to compare
the morbidity between the two groups. DESIGN: Prospective sampling of 102
patients who underwent diagnostic laparoscopy and laparoscopic appendectomy
for acute appendicitis and retrospective hospital chart review of 204
patients who underwent open appendectomy for acute appendicitis. RESULTS:
The mean +/- SD duration of surgery was 83 +/- 29 minutes in the
laparoscopic group and 64 +/- 30 minutes in the open appendectomy group (P
< .001). Hospital stay was shorter in the laparoscopic group (P <
.04). There was no difference in the complication rate between the patients
who underwent laparoscopic appendectomy (13%) and the patients who
underwent open appendectomy (11%). The occurrence of postoperative ileus
was correlated with the duration of operation (P < .01) but not with
laparoscopic appendectomy. CONCLUSIONS: The results confirm that
laparoscopic appendectomy had a longer time of surgery, a shorter hospital
stay, and no difference in complications. Further investigation will likely
establish that laparoscopic appendectomy can be considered the "gold
standard."
