Comparison Of Laparoscopic And Open Surgery In Patients With Complicated Appendicitis

Objective: To compare laparoscopic appendectomy(LA)and open appendectomy(OA) for complicated appendicitis and to evaluate the clinical significance of LA in treatment of complicated appendicitis.Methods: A retrospective analysis was performed of the patients with appendicitis received treatment in our hospital,from 2012.1 to 2014.1. 160 patients diagnosed with complicated appendicitis,including 65 patients with laparoscopic appendectomy and 95 patients with open surgery. Conversion of LA to OA occurred in 4 patients. We Compared the age, sex, time of onset, white blood cell counts, neutrophil granulocyte percentage,pathology type, amount of ascites, catheter drainage rate,operative time, blood loss, incision length, postoperative time out of bed, hospital stay, hospital costs,incidence of complications(wound infection rate, pulmonary infection rate, abdominal abscess rate, ileus rate)between the two groups of patients.Results: The age, sex, time of onset, white blood cell counts, neutrophil granulocyte percentage, pathology type, amount of ascites,catheter drainage rate,operative time, pulmonary infection, the incidence of adhesive intestnal obstruction and hospital costs have no statistical significance between the two groups(P>0.05). Compared with the volume of hemorrhage, bleeding volume in operation of laparoscopic group was 31.2±21.4ml, amount of bleeding in open group was 45.2±38.1ml, the difference of the groups was statistically significant(P < 0.05).The size of operation incision of traditional open appendectomy group and the laparoscopic appendectomy group were6.3±2.4cm and 2.2±0.5cm,there was statistically significant difference between two group(P<0.05).Postoperative time out of bed, laparoscopic group was 2.29±0.98 d, open group was 2.91±0.75 d, the difference of the groups was statistically significant(P<0.05).Postoperative flatus, laparoscopic group was 2.22±1.07 d,open group was 2.75±0.84 d, there was obvious statistically significant difference between two group(P<0.05).Hospital stay,laparoscopic group was7.26±3.16 d,open group was 8.55±4.85 d, the difference of the groups was statistically significant(P<0.05).The incidence of the complication were 4.9% and 16.8%, there was statistically significant difference between two group(P<0.05). Incision infection rate were 1.6% and 10.5%, the difference of the groups was statistically significant(P<0.05).Conclusion: Comparing with open appendectomy, laparoscopic appendectomy in the treatment of complicated appendicitis has its advantages,including minimal insection, shorter hospital stay time,rapid recovery,lower complications.It is may a effective treatment for complicated appendicitis.