Laparoscopic surgery versus open surgery for treatment of acute appendicitis

AIMS. Update of the most recent guidelines in the treatment of Acute Appendicitis prior to the analysis of our service experience in the treatment of these patients in the last years comparing the outcomes of open (OA) vs. laparoscopic appendectomy (LA). METHODS. Patients diagnosed with Acute Appendicitis who were admitted to our Surgery Department from January 2006, to January 2010, were divided in two groups: OA and LA according to the technique employed. A retrospective study was undertaken comparing the data obtained from medical records. RESULTS. A total of 339 patients were included in our study, 122 underwent Laparoscopic Appendectomy (mean age 32.95 years) and 177 had Open surgery (mean age 37.17 years). The post operative stay in days was 4.41 for LA and 3.72 for the OA group. The analysis of the complications showed that 10% of the patients on the OA group stayed more than 10 days hospitalized due to complications; in the LA group only 5.73% of patients had a prolonged stay. CONCLUSIONS: 1. According to recent studies when antibiotics were used as the sole treatment for acute appendicitis the rate of recurrence in the first year reaches 13.9%. 2. Evidence published about LA outcomes show fewer wound infection, more intra-abdominal abscess, longer operative time, less postoperative pain, shorter post operative stay, same time to return to work and grater administrative costs. 3. Our case series reports similar results to those published, with fewer postoperative complications including intra-abdominal abscesses. A larger sample is needed to extract definitive conclusions.