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A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study
BACKGROUND: Appendectomy is one of the most common operations. Laparoscopic appendectomy (LA) is considered first-line treatment, but the use of LA for treatment of complicated appendicitis remains controversial. Here, we performed a retrospective analysis to compare clinical outcomes between patien...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429533/ https://www.ncbi.nlm.nih.gov/pubmed/30710176 http://dx.doi.org/10.1007/s00068-019-01086-5 |
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author | Takami, Tomoya Yamaguchi, Tomoyuki Yoshitake, Hiroyuki Hatano, Kotaro Kataoka, Naoki Tomita, Masafumi Makimoto, Shinichiro |
author_facet | Takami, Tomoya Yamaguchi, Tomoyuki Yoshitake, Hiroyuki Hatano, Kotaro Kataoka, Naoki Tomita, Masafumi Makimoto, Shinichiro |
author_sort | Takami, Tomoya |
collection | PubMed |
description | BACKGROUND: Appendectomy is one of the most common operations. Laparoscopic appendectomy (LA) is considered first-line treatment, but the use of LA for treatment of complicated appendicitis remains controversial. Here, we performed a retrospective analysis to compare clinical outcomes between patients treated with LA and those who underwent open appendectomy (OA). METHODS: Data for 179 patients who underwent an operation for the treatment of complicated appendicitis at our hospital between 2011 and 2017 were retrospectively analyzed. The selection included 89 patients who underwent a conventional appendectomy and 90 patients who were treated laparoscopically. Outcome measures such as mean operative time, blood loss, time until oral intake duration of hospital stay, and postoperative complications were analyzed. Logistic regression analysis was performed to determine the concurrent effects of the examined factors on the rate of postoperative complications. RESULTS: The mean ages of patients in the OA and LA groups were 50.17 ± 22.77 and 50.13 ± 25.84 year. Mean operative times were longer in the LA group than OA (10.2.56 ± 44.4 versus 85.4 ± 43.11 min; p = 0.009). The duration of hospital stay was shorter for the LA group (9.61 ± 5.57 versus 12.19 ± 8.4; p = 0.016). There were no significant differences in return to consumption of oral intake between the LA and OA groups (2.03 ± 1.66 versus 2.48 ± 2.17; p = 0.123). Multivariable analysis found that the rate of postoperative complications was significantly reduced for the LA group, in comparison with the postoperative-complication rate of the OA group (16.7% versus 27%; odds ratio 0.376; 95% CI 0.153–0.923; p = 0.0327). CONCLUSIONS: These results suggest that LA is a safe and efficient operative procedure that provides clinically beneficial advantages in comparison with OA. Thus, when possible, appendectomy for complicated appendicitis should be attempted using a laparoscopic approach. TRIAL REGISTRATION: Retrospectively registered. |
format | Online Article Text |
id | pubmed-7429533 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-74295332020-08-19 A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study Takami, Tomoya Yamaguchi, Tomoyuki Yoshitake, Hiroyuki Hatano, Kotaro Kataoka, Naoki Tomita, Masafumi Makimoto, Shinichiro Eur J Trauma Emerg Surg Original Article BACKGROUND: Appendectomy is one of the most common operations. Laparoscopic appendectomy (LA) is considered first-line treatment, but the use of LA for treatment of complicated appendicitis remains controversial. Here, we performed a retrospective analysis to compare clinical outcomes between patients treated with LA and those who underwent open appendectomy (OA). METHODS: Data for 179 patients who underwent an operation for the treatment of complicated appendicitis at our hospital between 2011 and 2017 were retrospectively analyzed. The selection included 89 patients who underwent a conventional appendectomy and 90 patients who were treated laparoscopically. Outcome measures such as mean operative time, blood loss, time until oral intake duration of hospital stay, and postoperative complications were analyzed. Logistic regression analysis was performed to determine the concurrent effects of the examined factors on the rate of postoperative complications. RESULTS: The mean ages of patients in the OA and LA groups were 50.17 ± 22.77 and 50.13 ± 25.84 year. Mean operative times were longer in the LA group than OA (10.2.56 ± 44.4 versus 85.4 ± 43.11 min; p = 0.009). The duration of hospital stay was shorter for the LA group (9.61 ± 5.57 versus 12.19 ± 8.4; p = 0.016). There were no significant differences in return to consumption of oral intake between the LA and OA groups (2.03 ± 1.66 versus 2.48 ± 2.17; p = 0.123). Multivariable analysis found that the rate of postoperative complications was significantly reduced for the LA group, in comparison with the postoperative-complication rate of the OA group (16.7% versus 27%; odds ratio 0.376; 95% CI 0.153–0.923; p = 0.0327). CONCLUSIONS: These results suggest that LA is a safe and efficient operative procedure that provides clinically beneficial advantages in comparison with OA. Thus, when possible, appendectomy for complicated appendicitis should be attempted using a laparoscopic approach. TRIAL REGISTRATION: Retrospectively registered. Springer Berlin Heidelberg 2019-02-02 2020 /pmc/articles/PMC7429533/ /pubmed/30710176 http://dx.doi.org/10.1007/s00068-019-01086-5 Text en © The Author(s) 2019 OpenAccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. |
spellingShingle | Original Article Takami, Tomoya Yamaguchi, Tomoyuki Yoshitake, Hiroyuki Hatano, Kotaro Kataoka, Naoki Tomita, Masafumi Makimoto, Shinichiro A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study |
title | A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study |
title_full | A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study |
title_fullStr | A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study |
title_full_unstemmed | A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study |
title_short | A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study |
title_sort | clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429533/ https://www.ncbi.nlm.nih.gov/pubmed/30710176 http://dx.doi.org/10.1007/s00068-019-01086-5 |
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