Open appendectomy versus videolaparoscopic appendectomy: a short-term analysis

Abstract

Introduction: Appendectomy is a frequent surgery performed in emergency situations. It can be performed by open or laparoscopic approach. Objective: To analyze results and possible differences between open and laparoscopic appendectomies. To characterize epidemiologically operated patients and evaluate outcomes of both techniques in a short period. Methods: Historical cohort analysis of 238 patients diagnosed with acute appendicitis and undergoing open or laparoscopic appendectomy at the São José Regional Hospital Dr. Homero de Miranda Gomes, Santa Catarina, Brazil, from May 1, 2017 to April 30, 2018. Results: Among the patients analyzed, 209 (87.8%) underwent open appendectomy and 29 (12.2%) underwent laparoscopic appendectomy. The entire number of men operated on was higher than the number of women (141 versus 97). However, there were more women operated by the laparoscopic approach (58,7%; p = 0.04). In both approaches, the most common transoperative presentation of acute appendicitis was suppurative and there was a higher prevalence of patients between 21 and 30 years old. The laparoscopic approach had a lower rate of surgical site infection (3.4% versus 14.8% in the open appendectomy), although thidifference was not statistically significant (p = 0.09). The average operative time was longer (p <0.01) in laparoscopic surgeries (86 ± 27.37 minutes versus 62.7 ± 23.80 minutes). Regarding the length of hospital stay and postoperative abdominal pain, both approaches were similar. Conclusion: At the hospital evaluated, most of the appendectomies were performed by open approach and most laparoscopic appendectomies were performed on women. The laparoscopic technique had higher average execution time. There were no significant differences in relation to the surgical site infection rates, postoperative pain and length of hospital stay.