Acta clinica Croatica, Vol. 57. No. 3., 2018.
Original scientific paper
https://doi.org/10.20471/acc.2018.57.03.14
Laparoscopic Appendectomy does not Increase the Rate of Negative Appendectomy along with a Lower Rate of Perforated Appendicitis – Results in 1899 Patients at Zagreb UHC
Goran Augustin
orcid.org/0000-0002-0202-3324
; Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia
Zrinka Čižmešija
; School of Medicine, University of Zagreb, Zagreb, Croatia
Jurica Žedelj
; Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia
Igor Petrović
; Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia
Vanja Ivković
; Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Anko Antabak
; Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia
Davor Mijatović
; Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia
Mate Škegro
; Department of Surgery, Zagreb University Hospital Centre and School of Medicine, University of Zagreb, Zagreb, Croatia
Abstract
Laparoscopic appendectomy is the method of choice of many professional societies owing to its many advantages. The question arises whether surgeons urge more easily to laparoscopic exploration due to its less invasiveness, faster recovery and adequate exploration of the entire abdominal cavity than to observation in unequivocal cases. This retrospective analysis (2009-2016) included 1899 patients undergoing laparoscopic (lap) or gridiron intra-abdominal approach treated at Zagreb University Hospital Centre. The analysis included total negative appendectomy, negative-negative appendectomy (normal appendix and no other pathology found), and negative-positive appendectomy (normal appendix but another pathology found) in children (≤16 years) and adults. There was no statistically significant difference in the rates of negative appendectomy (children) – lap vs. open (p=0.24); negative appendectomy (adults) – lap vs. open (p=0.15); negative-negative appendectomy (children) – lap vs. open (p=0.36); negative-negative appendectomy (adults) – lap vs. open (p=0.21); negative-positive appendectomy (children) – lap vs. open (p=0.53); negative-positive appendectomy (adults) – lap vs. open (p=0.56); and laparoscopy group negative appendectomy in children vs. adults (p=0.56). There was a statistically significantly higher perforation rate with the open approach in total (p<0.0001), in children (p<0.0001) and in adults (p=0.02). There was no statistically significant difference between adults and children in the perforation rate with laparoscopic approach (p=0.24) and perforation rate with open approach (p=0.29). Results confirmed that there was no statistically significant difference in the rate of negative appendectomy in all subgroups. It is concluded that laparoscopic appendectomy should be offered as the method of choice in any patient population with suspicion of acute appendicitis.
Keywords
Appendicitis; Appendectomy; Laparoscopy; Croatia
Hrčak ID:
216144
URI
Publication date:
1.9.2018.
Visits: 1.783 *