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LAPAROSCOPIC VERSUS OPEN APPENDECTOMY: OUR EXPERIENCE AND LITERATURE REVIEW

MARIJAN KOLOVRAT ; Klinika za kirurgiju, Klinička bolnica Dubrava, Zagreb, Hrvatska
ZVONIMIR LOVRIĆ ; Klinika za kirurgiju, Klinička bolnica Dubrava, Zagreb, Hrvatska
ŽELJKO BUŠIĆ ; Klinika za kirurgiju, Klinička bolnica Dubrava, Zagreb, Hrvatska
FEDOR AMIĆ ; Klinika za kirurgiju, Klinička bolnica Dubrava, Zagreb, Hrvatska
VLATKA ČAVKA ; Klinička bolnica “Sestre milosrdnice”, Zagreb, Hrvatska
DRAŽEN SERVIS ; Klinika za kirurgiju, Klinička bolnica Dubrava, Zagreb, Hrvatska
ANDREJ ŠITUM ; Klinika za kirurgiju, Klinička bolnica Dubrava, Zagreb, Hrvatska
MISLAV ČAVKA ; Klinika za kirurgiju, Klinička bolnica Dubrava, Zagreb, Hrvatska
LEONARDO PATRLJ ; Klinika za kirurgiju, Klinička bolnica Dubrava, Zagreb, Hrvatska

Sažetak

Aim. The controversy of the choice between open and laparoscopic appendectomy still remains. The benefits as well as disadvantages of laparoscopy are well known. Methods. We designed a prospective 3-year clinical study (January 1,2008 – December 31,2010) with 123 patients operated on for acute appendicitis. They were prospectively divided into laparoscopic appendectomy (LA) group with 42 results and open appendectomy (OA) group with 81 results. The following parameters were analyzed: age, sex, preoperative leukocyte count, C-reactive protein (CRP) value, preoperative ultrasound finding (US), analgesic administration and histopathologic finding. The length of the operation, length of hospitalization (LOS) and complications were compared between the two groups, along with personal postoperative satisfaction estimated by telephone survey after discharge from the hospital. Results. In 90% of cases, histopathology was positive for inflammation. CRP was determined in 42 (34%) patients preoperatively, with a mean value of 59; positive histopathology finding was recorded in 31 (74%) patients with increased preoperative CRP. US was performed in 68 (55%) patients; positive US was consistent with histopathology in 44 (65%) cases. The mean time of LA/ OA was 75/72 minutes. The only statistical difference was found for LOS: 4 versus 6 days (p<0.01). Conclusion. LA and OA are comparable for the number of complications. The slight benefit of LA offers the surgeon free hand in decision when dealing with acute appendicitis needing urgent operation.

Ključne riječi

laparoscopy; acute appendicitis

Hrčak ID:

104182

URI

https://hrcak.srce.hr/104182

Datum izdavanja:

20.6.2013.

Podaci na drugim jezicima: hrvatski

Posjeta: 4.915 *