scholarly journals Comparison between laparoscopic and open appendectomy in pregnant women

2017 ◽  
Vol 4 (5) ◽  
pp. 1623
Author(s):  
Subba Rao Dova ◽  
Sankara Rao Pagoti ◽  
Manoj Kumar Mannem
Keyword(s):  
Acute Appendicitis ◽  
Pregnant Women ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Fetal Loss ◽  
P Value ◽  
Open Approach ◽  
Open Procedure ◽  
Gestational Age At Delivery ◽  
Group 2

Background: Acute appendicitis is the most common indication for surgical emergency in normal patients and also in pregnant women. The objective of this study was to study the clinical significance of a laparoscopic over an open approach to appendicectomy pregnant population.Methods: Total 46 cases patients with acute appendicitis confirmed the diagnosis by clinical examination and ultrasonography. The patients were divided into two groups laparoscopic appendectomy (group 1) n=21 and Open appendectomy (group 2) n=25. We retrospectively analyzed the medical records to compare the 2 groups.Results: All the demographic details are not significant when compared with each other. Laparoscopic appendectomy is significantly i.e. <p-value <0.05 less time for operation, length of stay in hospital and complication when compared with open procedure. Time to first flatus, leucocyte and neutrophil ratio are not significantly when compared laparoscopic appendectomy and open appendectomy. Preterm delivery, birth weight, APGAR score, gestational age at delivery, delivery type, fetal loss and maternal death were not significant when compared laparoscopic appendectomy and open appendectomy.Conclusions: Laparoscopic procedure is safe and effective technique for the treatment of appendicitis during pregnancy with nearly similar rates of complications compared to open procedure. Laparoscopic appendectomy associated with shorter hospital stay, faster return to daily activities and shorter time to first flatus.

scholarly journals Acute Appendicitis in Pregnant Women: Our Clinical Experience

2016 ◽  
Vol 39 (6) ◽  
pp. 159 ◽  
Author(s):  
Ahmet Türkan ◽  
Metin Yalaza ◽  
Mehmet Tolga Kafadar ◽  
Gürka Değirmencioğlu
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Pregnant Women ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Fetal Loss ◽  
University Research ◽  
Lower Quadrant ◽  
Right Lower Quadrant

Purpose: The purpose of this study was to analyse 13 patients who were treated in our clinic due to acute appendicitis during pregnancy. Methods: Records of the patients who received appendectomy with appendicitis diagnosis in our Turgut Özal University Research and Application Hospital between January 2007 and December 2015 have been analyzed retrospectively. Results: Appendectomies were performed on 13 pregnant patients with an acute appendicitis diagnosis. Average age of the patients was 27.69 years (between 22-37 years). Most frequent complaint of the patients was abdominal pain and most frequent examination finding was tenderness at right lower quadrant. Ultrasonography was used in all cases for diagnosis. Surgery was decided with clinical diagnosis for five cases (38.5%) where appendix had not been identified with ultrasonography. While laparoscopic appendectomy was applied in one case (7.7%) and open appendectomy was applied using a McBurney incision in 12 cases (92.3%). Average hospitalization duration was 1.69 days. All patients were tracked together through the Gynaecology Department for two weeks after they had been discharged from the hospital. Preterm delivery, maternal and fetal loss did not occur. Conclusion: It is considered appropriate to apply ultrasonography routinely to all pregnant patients in whom acute appendicitis is suspected. Concern for maternal or fetal complication that may occur in consequence of an unnecessary surgery should not be at a level that will delay surgical treatment needed by the patient.

scholarly journals Is the laparoscopic approach a safe choice for the management of acute appendicitis in pregnant women? A meta-analysis of observational studies

2019 ◽  
Vol 101 (4) ◽  
pp. 235-248 ◽  
Author(s):  
M Frountzas ◽  
C Nikolaou ◽  
K Stergios ◽  
K Kontzoglou ◽  
K Toutouzas ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Acute Appendicitis ◽  
Pregnant Women ◽  
Laparoscopic Appendectomy ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Open Appendectomy ◽  
Fetal Loss ◽  
Laparoscopic Approach ◽  
Increased Risk

IntroductionAcute appendicitis is a common and serious situation during pregnancy, because of the increased risk of fetal loss and perforation in the third trimester, as well as a diagnostic difficulty. During recent years laparoscopic approach has been introduced to clinical practice with encouraging results. The purpose of this meta-analysis is to compare the surgical and obstetrical outcomes between laparoscopic and open appendectomy during pregnancy.Materials and methodsMEDLINE, SCOPUS, Clinicaltrials.gov, CENTRAL and Google Scholar were searched for studies reporting on postoperative outcomes between laparoscopic and open appendectomy during pregnancy. The random effects model (DerSimonian–Laird) was used to calculate pooled effect estimates when high heterogeneity was encountered, otherwise the fixed-effects (Mantel–Haenszel) model was implemented.ResultsTwenty-one studies that enrolled 6276 pregnant women are included in the present meta-analysis. Of these women, 1963 underwent laparoscopic appendectomy and 4313 underwent an open appendectomy. Women who underwent laparoscopic appendectomy demonstrated an increase in fetal loss risk, while neonates of women that underwent open appendectomy presented decreased Apgar score at five minutes after birth. All the rest outcomes were similar between the two groups. The time that each study took place seemed to affect the comparison of birth weight and postoperative hospital stay between the two groups.ConclusionLaparoscopic appendectomy seems to be a relatively safe therapeutic option in pregnancy when it is indicated. Thus, it should be implemented in clinical practice, always considering the experience of the surgeon in such procedures. Nevertheless, the need of new studies to enhance this statement remains crucial.

Diabetes Mellitus and Cerebrovascular Disease as Independent Determinants for Increased Hospital Costs and Length of Stay in Open Appendectomy in Comparison with Laparoscopic Appendectomy: A Nationwide Cohort Study

2012 ◽  
Vol 78 (3) ◽  
pp. 329-334 ◽  
Author(s):  
Chun-Chieh Yeh ◽  
Chi-Hsun Hsieh ◽  
Chien-Chang Liao ◽  
Li-Ting Su ◽  
Yu-Chun Wang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Length Of Stay ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Hospital Costs ◽  
Cerebrovascular Diseases ◽  
Administrative Claims ◽  
Research Database ◽  
Open Approach

Comorbidity has been proven to increase hospital costs and length of hospital stays in patients receiving appendectomy for the treatment of acute appendicitis. However, the specific comorbidities that independently influence discrepancy of hospital costs and length of stay between open appendectomy and laparoscopic appendectomy still need to be elucidated. Using multi-variate linear analysis, administrative claims data were obtained from Taiwan's National Health Institute Research Database to compare differences of hospitalization costs and length of stay between open appendectomy and laparoscopic appendectomy categorized by various comorbidities defined in Charlson comorbidity score. Of 103,653 patients, 81,479 open appendectomies and 22,174 laparoscopic appendectomies were performed for the treatment of acute appendicitis in Taiwan between 2004 and 2008. In multilinear regression models, the adjusted costs and length of stay for open appendectomy in patients with cerebrovascular diseases or diabetes mellitus were significantly higher than that for laparoscopic appendectomy. To reduce costs and length of stay, patients with cerebrovascular diseases or diabetes mellitus should be particularly recommended to receive laparoscopic approach rather than an open approach for the treatment of acute appendicitis.

LAPAROSCOPIC APPENDECTOMY BECOMES THE METHOD OF CHOICE IN THE TREATMENT OF ACUTE APPENDICITIS

2008 ◽  
Vol 37 (2) ◽  
pp. 143-146
Author(s):  
Samir Delibegovic ◽  
Ervin Matovic
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Usual Method ◽  
Open Approach ◽  
Frequent Complication ◽  
Medical Centers ◽  
Duration Of Operation ◽  
Methods Of Treatment

Introduction: Laparoscopic appendectomy becomes a usual method in the treatment of acute appendicitis, although its advantage over open appendectomy has been proven. In Bosnia and Herzegovina, a few medical centers are introducing laparoscopic appendectomy as a method of treatment of acute appendicitis. In this study we want to compare different methods of treatment of acute appendicitis. Patients and Methods: During 20 months we have analyzed 498 patients operated due to acute appendicitis. We followed the duration of operation, total hospitalization stay, complications of surgical procedure and reasons of conversion in patients operated by laparoscopic approach. Results: The duration of operation was 96 minutes in the group operated by open approach and 107 minutes in the group operated by laparoscopic approach. Total hospitalization stay was 3.9. days in the group operated by open approach and 2.3. days in the group operated by laparoscopic approach. The most frequent complication in the group operated by open approach was infection of the operative wound (56/452) and ileus (5/452), and in the group operated by laparosocopic approach ileus (1/46) was the most frequent complication. Conclusion: The patients operated by laparoscopic approach have fewer risk of wound infection, and the hospital stay is shorter. With the increase of surgeon’s experience this method of treatment of acute appendicitis will become a method of choice.

scholarly journals A comparative study on surgical site infection in cases of open and laparoscopic appendicectomy

2018 ◽  
Vol 5 (10) ◽  
pp. 3309
Author(s):  
Priyansh Pandey ◽  
Manish M. Swarnkar ◽  
S. C. Jain
Keyword(s):  
Acute Appendicitis ◽  
Blood Cell ◽  
Surgical Site Infection ◽  
Clinical Features ◽  
White Blood Cell ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Appendicectomy ◽  
Open Approach ◽  
Site Infection

Background: Diagnosis of acute appendicitis is mostly based on clinical features pointing towards appendicitis. Several biochemical parameters, such as the white blood cell (WBC) count, and neutrophil percentage, are currently used to aid clinical diagnosis.  Without immediate surgery, appendicitis may progress to perforation of the appendix. This study was carried out to determine rate of SSI in open versus laparoscopic appendicectomy for acute appendicitis and to identify independent risk factors for SSI.Methods: Appendicitis is a common cause of pain in right iliac fossa worldwide. The present study was carried out in the Department of General Surgery, Acharya Vinoba Bhave Rural Hospital, affiliated to Jawaharlal Nehru Medical College, Sawangi, Wardha, from August 2015 to July 2017. This study was conducted after the due clearance from Institutional Ethical committee. Total 132 patients admitted to the surgery ward with acute lower abdominal pain with clinical features of acute appendicitis on clinical examination, were studied prospectively.Results: In the present study, maximum patients were seen in less than 20 years of age and next commonest age group of presentation was 21-30 years. The male to female sex ratio was 1:1.3 in the laparoscopic appendectomy group while in the open appendectomy group was 1.81:1. The incidence of complicated intra-operative findings and mean white blood cell count was more in the open appendectomy group. The mean operative time, days for use of analgesics, time taken to return to soft diet and length of hospital stay for laparoscopic appendectomy group was less than the open appendectomy group. There were more cases of surgical site infection in the patients operated by open approach than laparoscopic approach.Conclusions: Wound class II versus III and NNIS index were found to be significantly associated with surgical site infection.

scholarly journals The peculiarity of appendectomy of patients with high risk of cardiopulmonary insufficiency

2018 ◽  
Vol 22 (3) ◽  
pp. 456-459
Author(s):  
B.S. Zaporozhchenko ◽  
Hasan Yahya ◽  
I.I. Borodaev ◽  
V.N. Kachanov ◽  
O.A. Vasyliev
Keyword(s):  
High Risk ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Abdominal Cavity ◽  
Open Appendectomy ◽  
Pulmonary Insufficiency ◽  
Results Of Treatment ◽  
Cardiopulmonary Failure ◽  
Group 2 ◽  
Group 1

Acute appendicitis (AA) ranks first in the frequency of emergence of urgent surgical diseases in hospitals in Ukraine. In recent years, laparoscopic appendectomy has become one of the “gold standards” of surgery. Of particular interest in this group of patients is a gasless and with small amount of gas laparoscopy, in which the endosurgical space in the abdominal cavity is created with the help of endolifts, in which the abdominal wall is raised mechanically, without creating a pneumoperitoneum. Objective — to determine the feasibility and effectiveness of the use of various techniques for laparoscopic appendectomy of patients with a high risk of cardiopulmonary insufficiency. All patients with АA were divided into 2 groups: Group 1 — 72 patients with АA diagnosis, with a high risk of cardiopulmonary failure, who underwent open appendectomy; Group 2 — 85 patients with АA diagnosis with a high risk of cardiopulmonary failure, who underwent laparoscopic appendectomy with pneumoperitoneum and using laparolifting method of patients. The laparolifting was performed with the help of the device developed by the clinic for laparolifting on Zaporozhchenko-Kolodii. When analyzing the results of treatment of patients with IІ group, it should be noted that laparoscopic appendectomy, especially with laparolifting, may be the operation of choice in the treatment of patients with acute appendicitis. This technique is absolutely safe, reliable and affordable in the implementation of most surgeons. So, laparoscopic appendectomy can be performed in virtually all patients with acute appendicitis with high risk of cardio-pulmonary insufficiency with the avoidance of postoperative complications.

scholarly journals Laparoscopy superseding open appendectomy: a prospective view

2020 ◽  
Vol 7 (11) ◽  
pp. 3724
Author(s):  
Amol Deshpande ◽  
Shardul Khade
Keyword(s):  
Laparoscopic Appendectomy ◽  
Iliac Fossa ◽  
Tertiary Care ◽  
Open Appendectomy ◽  
Central India ◽  
Laparoscopic Group ◽  
P Value ◽  
Common Symptom ◽  
Care Hospital ◽  
Open Approach

Background: Appendicitis is the most common surgical disease with appendectomy being the traditional treatment of choice. Different operative procedures exist for appendectomy. The objectives of the study were to compare the efficiency of laparoscopic versus open appendectomy and to compare post-operative complications between laparoscopic and open appendectomy.Methods: This is a longitudinal study done from January 2018 till January 2020 in a tertiary care hospital of central India. A total of 400 operative patients were randomly selected and analysed with acute appendicitis (AA) as diagnosis. Sample size was randomized into two groups. Data was analysed with of open Epi version 2.3 and p value <0.05 was considered significant.Results: Most common symptom was pain in right iliac fossa (94.63%). 18.18% had perforation while 26.38% had inflamed appendix. Histopathological assessment showed that 8.3% and 2.87% had suppurative and gangrenous appendicitis respectively. 23.82% of the open cases reported with surgical site infection (SSI). No SSI were reported in the laparoscopic group. Post-op duration for open and laparoscopic appendectomy was 4.91±0.86 and 2.98±0.76 (p value=0.04150) and was found to be statistically significant.Conclusions: Open appendectomy is considered safe and effective but associated with complications such as ileus, intestinal obstruction, and wound sepsis. Laparoscopic appendectomy with high accuracy and low complication rate has emerged as the modus operandi and has superseded the open approach for treatment of AA.

scholarly journals Comparative study and outcome of open versus laparoscopic appendectomy: case series of 60 patients

2017 ◽  
Vol 4 (9) ◽  
pp. 3129
Author(s):  
Neeraj Sharma ◽  
Mayank Mishra ◽  
Alok Tripathi ◽  
Vivekanand Rai
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Case Series ◽  
P Value ◽  
Chi Square ◽  
Early Return ◽  
Group I ◽  
Duration Of Surgery ◽  
Open Versus

Background: Laparoscopic appendectomy combines the advantages of diagnosis and treatment in one procedure with least morbidity. Patients are likely to have less postoperative pain and to be discharged from hospital and return to activities of daily living sooner than those who have undergone open appendectomy.Methods: This prospective study was carried out in the Department of Surgery, Heritage IMS, Varanasi, from May 2016 to May 2017. All the patients were randomly divided into two groups, Group I (Lap App) and Group II (Open App). All quantitative data was compared by independent sample test. All qualitative data was compared by chi-square test. A p-value <0.05 was considered statistically significant.Results: In present study 19 (63%) patients of open appendectomy and 19 (63%) patients of laparoscopic appendectomy were males. 11 (36%) patients of open appendectomy and 11 (36%) laparoscopic appendectomy were females.Conclusions: This study from May 2016 to April 2017 was done on 60 (30 lap and 30 open) patients with clinical diagnosis of acute appendicitis admitted in surgical wards of Heritage Institute of Medical Sciences. In spite of drawback of the increase in duration of surgery, we conclude that laparoscopic appendectomy is better than the open method for acute appendicitis, with less post-operative pain and reduced duration of analgesics used, with lesser incidences of post-operative complications, shorter duration of hospital stays, early return to normal work.

scholarly journals Unligature method of laparoscopic appendectomy in children

2020 ◽  
Vol 10 (1) ◽  
pp. 53-58
Author(s):  
Vyacheslav G. Svarich ◽  
Evgeniy G. Perevozchikov ◽  
Ilya M. Kagantsov
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Operation Time ◽  
High Energy ◽  
Inflammatory Infiltration ◽  
Surgical Department ◽  
Clinical Hospital ◽  
Digital Assessment

Aim. On the basis of the accumulated clinical material to show the possibility of a ligature-free method of laparoscopic appendectomy in children. Materials and methods. From 2000 to 2019, 2044 children with acute appendicitis were treated in the surgical department of the Republican childrens clinical hospital in Syktyvkar. Of these, 651 patients had an open appendectomy with treatment of the stump of the vermiform process by the submersible method, 1363 children had a laparoscopic appendectomy with ligature treatment of the stump of the process, and 32 patients had their first non-ligature laparoscopic appendectomy with the intersection of the vermiform process with the Ligasure device. Results. On average, surgery for ligature-free laparoscopic appendectomy lasted 7 3 minutes less than for laparoscopic appendectomy using the ligature method for treating the stump of the worm-like process. Experimentally, it was found that this method of appendectomy should not be used when the thickness of the worm-like process is more than 1.5 cm, with pronounced inflammatory infiltration of the caecum dome and perforation at the base of the process. With ligature-free appendectomy, the operation time was reduced. In the period from 1 to 6 months, there were no intra-abdominal postoperative complications associated with the new method of surgery. Conclusion. Ligar-free laparoscopic appendectomy in children using modern high-energy platforms with a digital assessment of the degree of tissue coagulation readiness made it possible to avoid intraoperative and postoperative complications, simplify the technique of its implementation, and reduce the time of surgery.

scholarly journals Laparoscopic Appendectomy Trends and Outcomes in the United States: Data from the Nationwide Inpatient Sample (NIS), 2004–2011

2014 ◽  
Vol 80 (10) ◽  
pp. 1074-1077 ◽  
Author(s):  
Hossein Masoomi ◽  
Ninh T. Nguyen ◽  
Matthew O. Dolich ◽  
Steven Mills ◽  
Joseph C. Carmichael ◽  
...  
Keyword(s):  
United States ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Conversion Rate ◽  
Nationwide Inpatient Sample ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
The United States ◽  
Hospital Charges ◽  
Nationwide Inpatient Sample Database

Laparoscopic appendectomy (LA) is becoming the standard procedure of choice for appendicitis. We aimed to evaluate the frequency and trends of LA for acute appendicitis in the United States and to compare outcomes of LA with open appendectomy (OA). Using the Nationwide Inpatient Sample database, we examined patients who underwent appendectomy for acute appendicitis from 2004 to 2011. A total of 2,593,786 patients underwent appendectomy during this period. Overall, the rate of LA was 60.5 per cent (children: 58.1%; adults: 63%; elderly: 48.7%). LA rate significantly increased from 43.3 per cent in 2004 to 75 per cent in 2011. LA use increased 66 per cent in nonperforated appendicitis versus 100 per cent increase in LA use for perforated appendicitis. The LA rate increased in all age groups. The increased LA use was more significant in male patients (84%) compared with female patients (62%). The overall conversion rate of LA to OA was 6.3 per cent. Compared with OA, LA had a significantly lower complication rate, a lower mortality rate, a shorter mean hospital stay, and lower mean total hospital charges in both nonperforated and perforated appendices. LA has become an established procedure for appendectomy in nonperforated and perforated appendicitis in all rates exceeding OA. Conversion rate is relatively low (6.3%).

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