Laparoscopic versus open appendectomy
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Abstract
Introduction: The role of laparoscopy in the management of acute appendicitis already has an established role, with both clinical and hospital cost benefits, however in our environment studies are required to evaluate the results of laparoscopy for the management of acute appendicitis in children.
Objetive: Make a comparison of clinical outcomes between laparoscopic vs open appendectomy at the San Vicente Foundation Children's Hospital, and analyze the complications of these two surgical techniques
Methodology: This is a retrospective study that includes all patients between 6 months and 14 years of age diagnosed with acute appendicitis who underwent a laparoscopic or open appendectomy from May 2014 to May 2016. The different data were collected and analyzed using models for continuous variables; an alpha value <0.05 was established for statistical significance.
Results: A total of 517 appendectomies were performed (with an average of 4.9 appendectomies per week, 1.4 laparoscopic and 3.51 open). 29% (n = 151) of appendectomies were performed laparoscopically (LA) and 71% (n = 366) were open appendectomies (AA). Complications in LA correspond to 9.93% (n = 15), infection of the superficial operative site corresponds to 3.31% (n = 5). Infection of deep operative site at 3.31% (n = 5). The dehiscence of appendiceal stump 1.98% (n = 3) Complications in AA correspond to 18.30% (n = 67). The infection of superficial operative site corresponds to 10.68% (n = 39). Infection of deep operative site at 4.64% (n = 17). Two cases of appendiceal stump dehiscence were presented. The hospital stay for patients operated on by laparoscopy has an average of 3.7 days, and in open appendectomy an average of 4.11 days.
Conclusions: Laparoscopic appendectomy offers significant advantages in the treatment of acute appendicitis, as opposed to open appendectomy. Those who benefit the most are patients with complicated appendicitis; there are less comorbidities, an early onset of the oral route, fewer postsurgical complications such as the development of collections and a lower number of reoperations due to intestinal obstruction, which directly translates into a reduction in hospital stay and costs for the system Health.
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