engleski

Laparoscopis versus open surgical procedure in management of acute appendicitis: a prospective randomised study

AIM To show that laparoscopic appendectomy (LA) is advantageous procedure over open appendectomy (OA). METHODS Adult patients with presumptive diagnosis of acute appendicitis were prospectively randomised to either LA or OA group. General anaesthesia with antibiotic prophylaxis was applied. The following parameters were observed in both groups: duration of operation, quantity of analgesics used, wound infection, intra-abdominal abscess, duration and cost of hospitalisation. RESULTS A total of 100 patients were entered into the study, with 50 patients in each group.The groups were similar demographically (gender and mean age). No statistical differences between two groups were found in the case of intra- abdominal abscesses formation (0 vs 1, LA vs OA group) and cost of hospitalisation (median, HRK 5143 vs HRK 4585, LA vs OA group). OA group had shorter duration of operation (median, 57.5 vs 70.0 minutes ; P =0.003). LA group showed benefit in the quantity of analgesics used (median, 2 vs. 3 ; P<0.001), wound infection (0 vs. 8 ; P=0.006), and duration of hospitalisation (median, 3.0 vs. 5.0 days ; P<0.001). CONCLUSION Previously published trials on laparoscopic appendectomy did not show any significant benefit compared to the open approach in everyday surgical practice. Our study shows that laparoscopic appendectomy has advantages over open procedure in most of observed parameters.

Appendectomy; Laparoscopic; Classical

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