Laparoscopic versus open appendectomy for perforated appendicitis

الملخص EN

Objective : The aim of this study is to compare the different outcomes of laparoscopic with open appendectomy and ascertain their therapeutic benefits, if any, in the overall management of perforated acute appendicitis.

Methods : Data was collected from 60 cases admitted to a governmental hospital in South Africa over a one year interval (2009) with an intraoperative diagnosis of perforated acute appendicitis, 31 of them were managed laparoscopically (LA) while the other 29 cases were approached by an open appendectomy (OA).

Results : The procedure duration was significantly higher in the laparoscopic group (120 minutes for LA as opposed to 60 minutes for OA) ; the rate of intraabdominal sepsis was found to be lower in the LA group (6.4 % for LA compared to 13.7 % for OA).

Both groups showed no significant statistical difference in the hospital length of stay.

Also it was observed that the age, symptoms’ duration, clinical presentation and the white blood cell count (WBC) were influencing factors to the outcome measures of the OA group.

Conclusions : We conclude that perforated acute appendicitis can be managed successfully laparoscopically.

It is safe, feasible ; less influenced by preoperative findings and shows a trend towards less postoperative complications and can be considered as the procedure of choice for perforated acute appendicitis.