UNLABELLED: Acute appendicitis is the most common abdominal surgical emergency, but population-based data on the risk of complications after laparoscopic appendectomy (LA) and open appendectomy (OA) are scarce. THE AIM OF THE STUDY: To describe the risk of complications and mortality after appendectomy for acute appendicitis during a 10-year period, and to compare outcomes after LA and OA. MATERIAL AND METHODS: Using population-based registry data, we conducted a historical cohort study in a Danish region (population 2,000,000) including all patients who underwent appendectomy for acute appendicitis during the period of 1998-2007. We used logistic regression to compare the risk of complications and 30-day mortality between LA and OA, adjusting for gender, age, severity of appendicitis, time of surgery, and calendar year. Analyses were stratified for severity of appendicitis and time period. RESULTS: We included 18,426 patients. From 1998 to 2007 the use of LA rose from 12% to 61%, while the risk of surgically-treated complications fell from 5.7% to 3.2%, the risk of intra-abdominal infections fell from 2.4% to 1.1% and 30-day mortality fell from 0.30% to 0.23%. LA was associated with a lower risk of surgically-treated complications (adjusted odds ratio for LA vs. OA=0.70 (95% CI, 0.57-0.85), intraabdominal infections (OR=0.74 [95% CI, 0.55-0.99]) and mortality (OR=0.48 [95% CI, 0.18-1.30]). LA was safer than OA for simple and complicated appendicitis throughout the study period. CONCLUSIONS: Risk of complications and 30-day mortality decreased in Denmark between 1998 and 2007 concurrently with implementation of LA. The risk of complications was lower after LA than after OA.
UNLABELLED: Acute appendicitis is the most common abdominal surgical emergency, but population-based data on the risk of complications after laparoscopic appendectomy (LA) and open appendectomy (OA) are scarce. THE AIM OF THE STUDY: To describe the risk of complications and mortality after appendectomy for acute appendicitis during a 10-year period, and to compare outcomes after LA and OA. MATERIAL AND METHODS: Using population-based registry data, we conducted a historical cohort study in a Danish region (population 2,000,000) including all patients who underwent appendectomy for acute appendicitis during the period of 1998-2007. We used logistic regression to compare the risk of complications and 30-day mortality between LA and OA, adjusting for gender, age, severity of appendicitis, time of surgery, and calendar year. Analyses were stratified for severity of appendicitis and time period. RESULTS: We included 18,426 patients. From 1998 to 2007 the use of LA rose from 12% to 61%, while the risk of surgically-treated complications fell from 5.7% to 3.2%, the risk of intra-abdominal infections fell from 2.4% to 1.1% and 30-day mortality fell from 0.30% to 0.23%. LA was associated with a lower risk of surgically-treated complications (adjusted odds ratio for LA vs. OA=0.70 (95% CI, 0.57-0.85), intraabdominal infections (OR=0.74 [95% CI, 0.55-0.99]) and mortality (OR=0.48 [95% CI, 0.18-1.30]). LA was safer than OA for simple and complicated appendicitis throughout the study period. CONCLUSIONS: Risk of complications and 30-day mortality decreased in Denmark between 1998 and 2007 concurrently with implementation of LA. The risk of complications was lower after LA than after OA.
Authors: C Hüttenbrink; G Hatiboglu; T Simpfendörfer; J P Radtke; R Becker; D Teber; B Hadaschik; S Pahernik; M Hohenfellner Journal: Langenbecks Arch Surg Date: 2017-11-02 Impact factor: 3.445
Authors: Maciej Walędziak; Anna Lasek; Michał Wysocki; Michael Su; Maciej Bobowicz; Piotr Myśliwiec; Kamil Astapczyk; Mateusz Burdzel; Karolina Chruściel; Rafał Cygan; Wojciech Czubek; Natalia Dowgiałło-Wnukiewicz; Jakub Droś; Paula Franczak; Wacław Hołówko; Artur Kacprzyk; Wojciech Konrad Karcz; Jakub Kenig; Paweł Konrad; Arkadiusz Kopiejć; Adam Kot; Karolina Krakowska; Maciej Kukla; Agnieszka Leszko; Leszek Łozowski; Piotr Major; Wojciech Makarewicz; Paulina Malinowska-Torbicz; Maciej Matyja; Maciej Michalik; Adam Niekurzak; Damian Nowiński; Radomir Ostaszewski; Małgorzata Pabis; Małgorzata Polańska-Płachta; Mateusz Rubinkiewicz; Tomasz Stefura; Anna Stępień; Paweł Szabat; Rafał Śmiechowski; Sebastian Tomaszewski; Viktor von Ehrlich-Treuenstätt; Maciej Wasilczuk; Mateusz Wierdak; Anna Wojdyła; Jan Wojciech Wroński; Leszek Zwolakiewicz; Michał Pędziwiatr Journal: Sci Rep Date: 2019-10-15 Impact factor: 4.379
Authors: Thomas Jaschinski; Christoph G Mosch; Michaela Eikermann; Edmund Am Neugebauer; Stefan Sauerland Journal: Cochrane Database Syst Rev Date: 2018-11-28