Efficacy of emergency laparoscopic appendectomy in treating complicated appendicitis for elderly patients

OBJECTIVE: To assess the therapeutic effects of emergency laparoscopic appendectomy (LA) in treating complicated appendicitis (CA) for elderly patients (defined as age >65 years). METHODS: We conducted a retrospective study of 115 elderly patients with CA who underwent surgical therapy in the Affiliated Huizhou Hospital of Sun Yat-Sun University, Huizhou, Guangdong Province, China between September 2014 and August 2016. Of these, 59 patients consented to open appendectomy (OA), and LA was performed in the other 56 patients. The perioperative and follow-up variables of the 2 groups were analyzed. RESULTS: The operative time in the LA group was longer than the OA group (LA: 70.5±16.0 min versus [vs.] OA: 59.3±12.0 min, p<0.001). The LA group had lower chances of incision infections (LA: 8.9% vs. OA: 28.8 %, p=0.007) and shorter hospital stay (LA: 6.1± 2.5 days vs. OA: 9.6±3.5 days, p<0.001). Return to soft diet (LA: 1.4 ± 0.8 days vs. OA: 3.0 ± 1.6 days, p<0.001) and time to out of bed (LA: 1.3±0.5 days vs. OA: 2.5±0.9 days, p<0.001) was faster in the LA group. The incidence of complications and 30-day readmission rate in the LA group was much lower than the OA group. CONCLUSION: Emergency LA in treating elderly patients with CA has the advantages of less trauma, definite curative effect, low complication rates, and fast recovery when compared with OA.