A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy

• Published in: The American journal of surgery 1995-02, Vol.169 (2), p.208-213
• Main Authors: Ortega, Adrian E., Hunter, John G., Peters, Jeffrey H., Swanstrom, Lee L., Schirmer, Bruce
• Format: Article
• Language: English
• Subjects: Abscesses; Appendectomy; Appendicitis; Hospitals; Laparoscopy; Pain; Patients; Statistical analysis; Variance analysis; Vomiting; Wound infection
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/S0002-9610(99)80138-X

While the advantages of laparoscopic cholecyslectomy are clear, the benefits of laparoscopic appendectomy (LA) are more subtle. We conducted a randomized clinical trial to evaluate whether LA is deserving of more widespread clinical application than it has yet received. Two hundred fiftythree patients with a preoperative diagnosis of acute appendicitis were randomized into three groups. LA with an endoscopic linear stapler (LAS) (U.S. Surgical Corp., Norwalk, Connecticut) was performed on 78 patients, LA with catgut ligatures (LAL) on 89, and open appendectomy (OA) on 86. LA was performed with a three-trocar technique. OA was accomplished through a right lower-quadrant transverse incision. Data with normal distributions were analyzed by analysis of variance. Nonparametric data were analyzed with either the Kruskal-Wallis H test or Fisher's exact test. The mean operative times for the procedures were 66 ± 24 minutes (LAS), 68 ± 25 minutes (LAL), and 58 ± 27 minutes (OA). The relative brevity of OA compared to LAS and LAL was statistically significant ( P