BACKGROUND: The comparison of laparoscopic to open appendectomy has been reviewed in many retrospective and prospective studies. Some report shorter hospital stays, less postoperative pain, and earlier return to work while others fail to demonstrate such differences. We performed a prospective, randomized double-blinded trial to evaluate this ongoing debate. METHODS:Fifty-two consecutive men presenting with signs and symptoms suggestive of acute appendicitis were randomized to undergo either laparoscopic appendectomy or open appendectomy. Length of operative times, hospital stay, lost work days, visual analog pain scores, and operative costs were compared. RESULTS:Length of stay averaged 21.5 h for the laparoscopic group and was not statistically different when compared to the open group. Perceived postoperative pain on postoperative days 1 and 7 were not statistically different between the two groups. Mean time to return to work was 11 days, and there was no statistical difference between groups. Operative costs were >600 dollars greater for the laparoscopic approach. CONCLUSIONS: In this prospective randomized double-blinded trial, laparoscopic appendectomy appears to confer no significant advantage over open appendectomy for postoperative pain or lost work days. It does carry an increase in operating room costs and, contrary to other reports, hospital stay is not shortened. Further studies are needed to determine if specific populations, such as the obese or women, may benefit from a minimally invasive approach to appendicitis.
RCT Entities:
BACKGROUND: The comparison of laparoscopic to open appendectomy has been reviewed in many retrospective and prospective studies. Some report shorter hospital stays, less postoperative pain, and earlier return to work while others fail to demonstrate such differences. We performed a prospective, randomized double-blinded trial to evaluate this ongoing debate. METHODS: Fifty-two consecutive men presenting with signs and symptoms suggestive of acute appendicitis were randomized to undergo either laparoscopic appendectomy or open appendectomy. Length of operative times, hospital stay, lost work days, visual analog pain scores, and operative costs were compared. RESULTS: Length of stay averaged 21.5 h for the laparoscopic group and was not statistically different when compared to the open group. Perceived postoperative pain on postoperative days 1 and 7 were not statistically different between the two groups. Mean time to return to work was 11 days, and there was no statistical difference between groups. Operative costs were >600 dollars greater for the laparoscopic approach. CONCLUSIONS: In this prospective randomized double-blinded trial, laparoscopic appendectomy appears to confer no significant advantage over open appendectomy for postoperative pain or lost work days. It does carry an increase in operating room costs and, contrary to other reports, hospital stay is not shortened. Further studies are needed to determine if specific populations, such as the obese or women, may benefit from a minimally invasive approach to appendicitis.
Authors: L Enochsson; A Hellberg; C Rudberg; G Fenyö; T Gudbjartsson; E Kullman; I Ringqvist; S Sörensen; J Wenner Journal: Surg Endosc Date: 2001-02-06 Impact factor: 4.584
Authors: M R Cox; J L McCall; J Toouli; R T Padbury; T G Wilson; D A Wattchow; M Langcake Journal: World J Surg Date: 1996 Mar-Apr Impact factor: 3.352
Authors: R C Frazee; J W Roberts; R E Symmonds; S K Snyder; J C Hendricks; R W Smith; M D Custer; J B Harrison Journal: Ann Surg Date: 1994-06 Impact factor: 12.969
Authors: L C Martin; I Puente; J L Sosa; A Bassin; R Breslaw; M G McKenney; E Ginzburg; D Sleeman Journal: Ann Surg Date: 1995-09 Impact factor: 12.969
Authors: Hossein Masoomi; Steven Mills; Matthew O Dolich; Noor Ketana; Joseph C Carmichael; Ninh T Nguyen; Michael J Stamos Journal: World J Surg Date: 2012-07 Impact factor: 3.352
Authors: Andrew J Page; Jonathan D Pollock; Sebastian Perez; S Scott Davis; Edward Lin; John F Sweeney Journal: J Gastrointest Surg Date: 2010-08-19 Impact factor: 3.452