Society of Surgical Oncology SSO 2023 - International Conference on Surgical Cancer Care
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Background: Appendectomy is a widespread emergency surgery, and to date the appendectomy is still done through two approaches: open (OA) and laparoscopic (LA) and it is not known which is better than the other.Objective: This study aimed to compare OA and LA surgical approaches in patients with acute appendicitis.Patients and methods: Data were obtained from eighty patients underwent appendectomy at Baquba Teaching Hospital between September 2021 and May 2022.Forty patients in (OA) group underwent open surgery, as well as forty other patients in (LA) group underwent laparoscopic surgeries.The two groups were compared according to the operation time, hospital stay, wound infection, and return to normal daily activity.Results: LA approach was associated with shorter (1.4±0.6 days) hospitalization than OA (2.7±2.5 days).Also, the operative time of the laparoscopic approach was clearly less (30±3.2min) compared to the open approach (35±5.2min).There was no postoperative infection in the LA patients, and the laparoscopic patients returned to their daily activities faster than the open surgery group.Conclusion: Laparoscopic surgery is a safer approach to appendectomy, especially if it is performed by skilled specialist surgeons.
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Background: Nowadays laparoscopic appendectomy (LA) is the management of choice for acute appendicitis (AA) in simple, uncomplicated cases.For complicated acute appendicitis (CAA), laparoscopic or conventional open appendectomy (OA) is still in debate.Objective: This study aimed to compare minimally invasive LA and traditional OA in CAA cases.Methods: In this study, 44 patients with CAA (22 for LA and 22 for OA) with 18 years of age or older were enrolled.It was conducted in General Surgery Department, Helwan University Hospital. Results:The operative time difference between the LA and OA groups was statistically significant (18.5 minutes shorter in the OA group, (p<0.001).The median length of hospital stay, return to normal activity, and patient satisfaction were significantly better in the LA group (p-values of 0.001, 0.00, and 0.14 respectively).The need for analgesics in the LA group was significantly lower than in the OA group.There were no detectable statistically significant findings concerning the occurrence of surgical findings, postoperative vomiting, postoperative ileus, wound infection, wound dehiscence, or postoperative intra-abdominal collection.Conclusions: Laparoscopic appendectomy management of CAA is feasible, safe, and has numerous advantages over the traditional open procedure in terms of reducing postoperative pain, requiring fewer analgesics, shortening the postoperative hospital stay, having a low incidence of postoperative infectious complications, and allowing a rapid return to daily activities with improved comfort and satisfaction.
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Jong Min Kim, M.D., Sung Ryol Lee, M.D., Hyung Ook Kim, M.D., Ph.D., Won Joon Choi, M.D., Ph.D., Byung Ho Son, M.D., Ph.D.. J Minim Invasive Surg 2013;16:98-103. https://doi.org/10.7602/jmis.2013.16.4.98
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Professor of Surgery at the New York Post-Graduate Medical School and Hospital; Attending Surgeon to the German Hospital; Consulting Surgeon to the New York Skin and Cancer Hospital and to the New York Infirmary.
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Objectives: postoperative surgical complications of sepsis in patients are debated with complicated acute appendicitis treated with laparoscopic appendectomy (LA).The aim of this study was to investigate the results of LA in both complicated and uncomplicated cases of acute appendicitis.Methods: From December 2016 to December 2018, 80 patients with acute appendicitis underwent LA by the same surgery team using the three-port technique.Data were collected and compared between complicated and uncomplicated acute appendicitis.Results: Of the 80 patients (35 were women and 45 are men), 58 were uncomplicated and 22 are complicated acute appendicitis.The group with complicated acute appendicitis, as compared to the uncomplicated group, was significantly older (60 to18.5 years vs. 41.0 to 18.0 years), and had a significantly increased operation time (117 -50 minutes vs. 90 -50 minutes),longer length of hospital stay (12-4 days vs. 5-6.0days) and higher conversion rate(25% vs. 3%).No increase in surgical complications were noted in the patients with complicated acute appendicitis, as compared to those with uncomplicated acute appendicitis. Conclusion:This study demonstrated no increase in surgical complications after LA in patients with complicated acute appendicitis when compared with those who had uncomplicated disease.Therefore, LA may be considered the first-choice treatment option for both uncomplicated and complicated acute appendicitis.
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