Clinic Study Of Laparoscopic Appendectomy(LA) For Appendicitis Compare With Conventional Operation Appendectomy (CA)

Objective To compare and evaluate the effect of laparoscopic appendectomy(LA) and Conventional operation Appendectomy (CA) in appendicitis.Methods From Jan 2003 to Dec 2006,627 patients with appendicitis were underwent operation.Among them,185 cases with simple appendicitis,98 cases with suppurative appendicitis and 32 cases with gangrenous appendicitis were treated with laparoscopic appendectomy while 312 cases(160 cases with simple appendicitis,116 cases with suppurative appendicitis and 36 cases with gangrenous appendicitis) with conventional operation appendectomy.The operation time,recovery period, complications,and the period and the cost for hospitalizing were studied. Results All the operations were successful.The operating duration of laparoscopic appendectomy(LA) group and Conventional operation Appendectomy(CA) group were(26±3.2) min and(30±1.6) min(P＜0.05),the blood lost were(15±2.9) ml and(29±5.2) ml(P＜0.05),the bed off activity time were(49±1.1) h and(51±2.1) h(P＜0.05),the bowels' move time were(49±1.6) h and(52±4.6) h(P＜0.05),the length of incision were 2.5±0.5 cm and 6.5±1.3 cm,the incision infection rate were0.0% and 2.8%(P＜0.05),the rate of chronic abdominal pain with peritoneal adhesion were 2.2%and 6.4%(P＜0.05),the using rate of drug to stop pain were 3.8%and 31.4%,the intestinal obstruction rate were 0.0%and 1.2% (P＜0.05),the average hospitalized days were(5±0.9)d and(7±1.2) d (P＜0.05),the cost of hospitalizing were(6591±41) yuan and(4860±32) yuan(P＜0.05).The complications of laparoscopic appendectomy(LA) included blood vessel injury(n=3,0.95%),postoperative introabdominal abscess(n=0,0.00%),incision infection(n=0,0.00%),and chronic abdominal pain with peritoneal adhesion(n=7,2.22%).The causes for these complications were severity of the disease,standardization and proficiency of the laparoscopic technical skill.Conclusion Compared with traditional operation appendectomy,laparoscopic appendectomy is a more popular choice for the patients with acute appendicitis because of its advantages of minimal invasion,early recovery,few complications and short hospitalization time.Proficiency of the laparoscopic technical skill is important for the safety and efficacy laparoscopic appendectomy.