Laparoscopic Appendectomy: Is it the Gold Standard Approach for Management of Acute Appendicitis?
MA Bahram
Citation Information :
Bahram M. Laparoscopic Appendectomy: Is it the Gold Standard Approach for Management of Acute Appendicitis?. World J Lap Surg 2014; 7 (3):116-120.
Evaluation of laparoscopic approach for management of patients with confirmed or suspected acute appendicitis.
Background
Although appendicitis is the most common condition requiring surgery in patients with right lower abdominal pain, this pain can be indicative of a vast list of differential diagnoses and is thus a challenge for clinicians. A definite diagnosis is obtained in 96% of patients undergoing laparoscopic appendectomy (LA) compared with 72% of those undergoing open procedures so patients can avoid the disadvantages of misdiagnosis beside other benefits of La.
Study design
A prospective outcome analysis was done for 573 patients over the last 6 years, from 2008 to 2013. All patients were planned to go for la. Modified Alvarado scoring system was used as a guide in diagnosing all patients. The following were recorded: operative time, conversion to open procedure, intraoperative findings, infection complications and length of hospital stay.
Results
The mean operative time in this study was 42 ± 17.54 minutes. Nonappendiceal pathology was found in 31 patients (5.4%). Conversion to open procedure was done in 11 patients (1.9%). The accurate pathology was detected in 535 (93.3%) patients. The infection complications had occurred in 16 patients (2.6% of all patients). The mean hospital stay in this study was 1 ± 0.21 days.
Conclusion
Laparoscopic appendectomy is safe and can provide less postoperative morbidity, accurate method in diagnosing abdominal pathology other than acute appendicitis, and drawbacks of undiagnosed or misdiagnosed pathology that mimic acute appendicitis can be avoided.
Abbreviations
OA: Open appendectomy; LA: Laparoscopic appendectomy; CT: Computed tomography; ECG: Electrocardiography; SPSS: Statistical package for the social sciences; DM: Diabetic mellitus; HCV: Hepatitis C virus; IAA: Intra-abdominal abscess.
How to cite this article
Bahram MA. Laparoscopic Appendectomy: Is it the Gold Standard Approach for Management of Acute Appendicitis? World J Lap Surg 2014;7(3):116-120.
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