Laparoscopic versus open appendectomy: prospective randomized trial
| Autor: | D. Wall, Bernard Mark Smithers, Brian J. Miller, Betty Lynette Menzies, John Brendan Hansen, David Schache |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment law.invention Randomized controlled trial law Laparotomy medicine Appendectomy Humans Surgical Wound Infection Prospective Studies Prospective cohort study Laparoscopy Aged medicine.diagnostic_test business.industry General surgery Middle Aged medicine.disease Appendicitis Appendix Surgery medicine.anatomical_structure Cardiothoracic surgery Female business Abdominal surgery |
| Zdroj: | World journal of surgery. 20(1) |
| ISSN: | 0364-2313 |
| Popis: | A prospective randomized trial comparing laparoscopic appendectomy with open appendectomy in patients with a diagnosis of acute appendicitis was conducted between October 1992 and April 1994. Of the 158 patients randomized, 7 patients were excluded because of protocol violations (conversion to laparotomy in 4, appendix not removed in 3). The 151 patients randomized to either a laparoscopic (n = 79) or an open appendectomy (n = 72) showed no difference in sex, age, American Society of Anesthesiology (ASA) rating, or previous abdominal surgery. The histologic classification of normal, catarrhal, inflamed, suppurative, and gangrenous appendicitis was not different between the two groups. Conversion from laparoscopic to open appendectomy was necessary in seven patients (9%) who had advanced forms of appendiceal inflammation. When compared to open appendectomy the laparoscopic group had a longer median operating time (63 minutes versus 40 minutes), fewer wound infections (2% versus 11%), less requirement for narcotic analgesia, and an earlier return to normal activity (median 7 days versus 14 days). There was no difference in morbidity, and both groups had a median time to discharge of 3 days. Laparoscopic appendectomy is as safe as open appendectomy; and despite the longer operating time, the advantages such as fewer wound infections and earlier return to normal activity make it a worthwhile alternative for patients with a clinical diagnosis of acute appendicitis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink