Comparison of Laparoscopic and Open Appendectomies

Lim, Deok Mann; Jung, Seung Kyu; Jung, Yong Hwan; Choi, Kun Phil

Abstract

BACKGROUND: Kurt Semm, a German gynecologist, was first to describe a laparoscopic appendectomy for an incidental appendectomy in gynecologic surgery. At that time, it was limited to an incidental appendectomy performed during gynecologic surgery. The development of laparoscopic instruments and more experience has allowed surgeons to perform laparoscopic surgery easier than before. Nowadays, laparoscopy allows surgeons to perform appendectomies in a safe and effective way, and it reduces the risk of performing unnecessary appendectomies.
METHODS
We reviewed the records of 201 patients who had an appendectomy at our hospital from February 1997 to December 1997. A laparoscopic appendectomy was carried out in 51 cases, and an open appendectomy was carried out in the others.
RESULTS
1) There was not a significant difference between the two groups in regard to age and sex. The male-to-female ratios were 1.32:1 in laparoscopic appendectomy group and 1.17:1 in the open appendectomy group. The mean ages were 30.3 years in laparoscopic appendectomy group and 29.7 years in open appendectomy group. 2) There was not a significant difference in pathologic severity between the two groups. The majority had suppurative appendicitis in both groups. Postoperative complications were less frequent in the open appendectomy group. 3) The mean operative times were 55.6 minutes in the laparoscopic appendectomy group and 42 minutes in the open appendectomy group. 4) The mean hospital stays were 4.69 days in the laparoscopic appendectomy group and 6.96 days in the open appendectomy group. 5) The mean postoperative periods until normal activity were 8.79 days in the laparoscopic appendectomy group and 12.85 days in the open appendectomy group. 6) The postoperative use of analgesics was less frequent in the laparoscopic appendectomy group. 7) Conversion to an open laparotomy occurred in 3 cases.
CONCLUSIONS
We think that a laparoscopic appendectomy is a safer, more effective, more cosmetic, and less invasive procedure than an open appendectomy.