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Acta medica Croatica : Časopis Akademije medicinskih znanosti Hrvatske, Vol. 66 No. 5, 2012.

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LAPAROSCOPIC VERSUS OPEN APPENDECTOMY: OUR EXPERIENCE AND LITERATURE REVIEW

MARIJAN KOLOVRAT ; Department of Surgery, Dubrava University Hospital, Zagreb, Croatia
ZVONIMIR LOVRIĆ ; Department of Surgery, Dubrava University Hospital, Zagreb, Croatia
ŽELJKO BUŠIĆ ; Department of Surgery, Dubrava University Hospital, Zagreb, Croatia
FEDOR AMIĆ ; Department of Surgery, Dubrava University Hospital, Zagreb, Croatia
VLATKA ČAVKA ; Sestre milosrdnice University Hospital, Zagreb, Croatia
DRAŽEN SERVIS ; Department of Surgery, Dubrava University Hospital, Zagreb, Croatia
ANDREJ ŠITUM ; Department of Surgery, Dubrava University Hospital, Zagreb, Croatia
MISLAV ČAVKA ; Department of Surgery, Dubrava University Hospital, Zagreb, Croatia
LEONARDO PATRLJ ; Department of Surgery, Dubrava University Hospital, Zagreb, Croatia

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Abstract

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.

Keywords

laparoscopy; acute appendicitis

Hrčak ID:

104182

URI

https://hrcak.srce.hr/104182

Publication date:

20.6.2013.

Article data in other languages: croatian

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