Appendicitis Research Today is a free monthly online journal that collates and summarizes the latest research about Appendicitis, including details on symptoms, surgery, causes, treatment.

Laparoscopic appendectomy in a district hospital: does the technique influence the outcome?

Hussain A, Mahmood H, Singhal T, Balakrishnan S, El-Hasani S

Department of General Surgery, Princess Royal University Hospital, Kent, UK. azahrahussain@yahoo.com

BACKGROUND: Laparoscopic appendicectomy (LA) has proved to be a safe, effective procedure for appendicitis. However, its application in the current surgical practice is still far less than the laparoscopic cholecystectomy. Therefore, its role as a gold standard operation for acute appendicitis (AA) is less well established. METHODS: Between September 1999 and January 2007, a series of 200 patients (112 female, 88 male) with AA underwent LA in our surgical unit. A single consultant surgeon performed all the cases. Outcomes, including the length of stay, operative time, and complications, were evaluated. Follow-up assessment of patients was performed by outpatient appointment. RESULTS: The indications for LA were clinical diagnosis of AA for 177 patients (85%) and interval appendicectomy for 23 patients (15%). The mean age of these patients was 18.8 years (range, 8-83). Operative diagnosis of inflamed appendix, including perforated appendicitis in 9 patients (7.5%), was made in 139 patients (69.5%), and the appendix was macroscopically normal in 40 patients (20%). Different pathologies were found in 21 patients (11.5%). Of the 40 (20%) macroscopically normal appendices, 10 (5%) appendices were reported as inflamed by histopathology examination. The operative time ranged from 13 to 62 minutes, with a mean of 18 minutes. Minor morbidity was reported in 11 patients (5.5%) CONCLUSION: In experienced hands using a meticulous technique, LA provides diagnostic and therapeutic options, decreased operative time, rapid recovery, short hospital stay, fewer postoperative complications, and no intra-abdominal abscesses. Appendicectomy has cured right iliac fossa pain in almost all the patients.

Published 31 March 2008 in J Laparoendosc Adv Surg Tech A, 18(2): 204-8.
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