Cristina González (Burgos / ES), Luis Casaval Cornejo (Burgos / ES), Michelle C. Otero Rondon (Burgos / ES), David Jorge Tejedor (Burgos / ES), Romina Ferlini (Burgos / ES), Nerea Muñoz Plaza (Burgos / ES), Lucia Polanco Perez (Burgos / ES), Idoia Dominguez Arroyo (Burgos / ES), Luciano Ferrando (Burgos / ES), Guillermo Cabriada García (Burgos / ES), José Felipe Reoyo Pascual (Burgos / ES), Romina Parra Lopez (Burgos / ES), Alberto Palomo (Burgos / ES), Miguel Ángel Á. Rico (Burgos / ES)
Abstract text (incl. references and figure legends)
INTRODUCTION: There are three operative modalities for appendectomy: open appendectomy (OA), laparoscopic appendectomy (LA) and single port laparoscopic appendectomy (SPLA). This study aimed to compare these procedures.
MATERIAL AND METHODS: This was a 2-year retrospective study From January 2020 to May 2022, A retrospective study was carried out on a tertiary hospital with 485 patients diagnosed with acute appendicitis in emergency department. We reviewed all clinical histories and data analysis was performed from a descriptional point of view.
RESULTS:485 adults (48% female) were diagnosed with acute appendicitis. Diagnose was made by clinical, laboratory and radiological findings. 80% patients were diagnosed by ultrasound. Nearly 73% of the cases had an LA, with 23% an OA, and 6% a SPLA. A total of 4% LA cases were converted to OA. Operation time was different; LA with 55 minutes, OA with 45 minutes and SPLA with 65 minutes. There were no differences in the antibiotic prophilaxis, postoperative pain, start of oral intake and deambulation. Length of hospital stay was 3 days for LA, 4 days for OA and 2,5 days por SPLA. Readmission was higher in OA with 5% vs 2% in LA group. No readmission por SPLA. Complicated appendicitis accounted for 37% of the patients with LA, 32% for OA and 47% for SPLA. Adenocarcinoma was presented in 3 patients: 2 in LA group and 1 in OA group. Posoperative complications were analysed by Claven-Dindo scale. 4.7% of LA presented Claven-Dindo > III grade, this was similar for OA. SPLA did not present post-operative complications. There were more re-operations OA group (3%) versus LA (0.5%) and SPLA (0%). Incisional hernia was evaluated in all patients with one case in SPLA versus two cases in LA and one in OA.
CONCLUSION: LA, OA, SPLA seem to have comparable efficacy and safety in adults with diagnosis of acute appendicitis. These three procedures are comparable in terms of complications, post-operative pain and recovery.
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