Abstract

Objective: This study aimed to compare the intraoperative and postoperative outcomes of laparoscopic appendectomy (LA) and open appendectomy (OA) in patients diagnosed with acute appendicitis, with a focus on surgical outcomes and recovery parameters.

Methods: A retrospective analysis was conducted on 376 patients who underwent appendectomy for acute appendicitis at İzmir City Hospital between October 15, 2023, and August 15, 2024. Patients were grouped based on surgical approach (LA or OA). Data on demographic characteristics, body mass index (BMI), operative duration, intraoperative blood loss, time to oral intake, length of hospital stay, return-to-work time, and postoperative complications were collected and analyzed. Statistical significance was defined as p < 0.05.

Results: Of the 376 patients, 251 underwent LA and 125 underwent OA. The mean operative duration was significantly longer in the LA group (102.56 ± 44.4 minutes vs. 85.4 ± 43.11 minutes, p = 0.009). However, intraoperative blood loss was significantly lower in the LA group (29.64 ± 62.97 mL vs. 74.79 ± 168.55 mL, p = 0.018). Postoperative pain scores (VAS) were significantly lower in LA patients, and they experienced a shorter hospital stay and faster return to work (p < 0.001). The incidence of wound infections was lower in the LA group compared to the OA group (5% vs. 12%, p = 0.03). Conversion from LA to OA occurred in 2.9% of cases due to intraoperative complications such as bleeding, perforation, or inadequate visualization.

Conclusion: Laparoscopic appendectomy demonstrated favorable postoperative outcomes compared to open appendectomy, including reduced postoperative pain, shorter hospital stays, and quicker recovery. These results support the adoption of LA as a safe and effective alternative to OA, particularly in patients with higher BMI or less severe disease presentations. Nonetheless, larger prospective randomized studies are required to confirm these findings and better define the optimal indications for LA in clinical practice.

Keywords: Acute appendicitis, Laparoscopic appendectomy, Open appendectomy, Postoperative outcomes, Minimally invasive surgery

How to Cite

1.
Eker B, Ercan M, Dincsoy C, Sel S, Guner M, Kamer KE. Comparison of laparoscopic and open appendectomy outcomes in acute appendicitis. J Trends Med Invest. 2025;1(1):20-3.

References

  1. Li X, Zhang J, Sang L, Zhang W, Chu Z, Li X, Liu Y. Laparoscopic versus conventional appendectomy-a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2010;10:129. https://doi.org/10.1186/1471-230X-10-129
  2. Dai L, Shuai J. Laparoscopic versus open appendectomy in adults and children: A meta-analysis of randomized controlled trials. United European Gastroenterol J. 2017;5(4):542-553. https://doi.org/10.1177/2050640616661931
  3. Markar SR, Blackburn S, Cobb R, Karthikesalingam A, Evans J, Kinross J, et al. Laparoscopic versus open appendectomy for complicated and uncomplicated appendicitis in adults: a meta-analysis. Surg Endosc. 2012;26(4):1199-1208.
  4. Salminen P, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, et al. Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis: the APPAC randomized clinical trial. JAMA. 2015;313(23):2340-2348. https://doi.org/10.1001/jama.2015.6154
  5. Sauerland S, Jaschinski T, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2010;(10):CD001546. https://doi.org/10.1002/14651858.CD001546.pub3
  6. Guller U, Hervey S, Purves H, Muhlbaier LH, Peterson ED, Eubanks S, et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg. 2004;239(1):43-52. https://doi.org/10.1097/01.sla.0000103071.35986.c1
  7. Swank HA, van Rossem CC, van Geloven AA, Bemelman WA, group LAt. Laparoscopic appendectomy versus open appendectomy for complicated appendicitis (LAFA trial): study protocol for a randomized controlled trial. Trials. 2015;16:1-7.
  8. Mason RJ, Moazzez A, Moroney JR, Katkhouda N. Laparoscopic vs open appendectomy in obese patients: outcomes using the American College of Surgeons National Surgical Quality Improvement Program database. J Am Coll Surg. 2012;215(1):88-99. https://doi.org/10.1016/j.jamcollsurg.2012.03.012