Laparoscopic appendectomy versus open appendectomy: retrospective assessment of 200 patients.

OBJECTIVE: To compare laparoscopic appendectomy (LA) with traditional methods as the primary treatment for acute appendicitis. DESIGN: A retrospective case series. SETTING: A regional, nonuniversity hospital in northwestern Quebec. PATIENTS: Two hundred patients with a clinical diagnosis of acute appendicitis: 100 (43 men, 57 women; mean age 27 years) underwent laparoscopic appendectomy and 100 (67 men, 33 women; mean age 21 years) had an open appendectomy (OA). INTERVENTIONS: LA or OA. MAIN OUTCOME MEASURES: Operating time, rate of conversion to OA, need for analgesia, morbidity and outcome. RESULTS: LA was successful in 88% of patients. The mean operating time was 50 minutes for LA versus 24 minutes for OA. On average, patients of the LA group had a 1-day decrease in postoperative hospital stay (2.6 versus 3.6 days). The wound infection rate was lower in the LA group (2% versus 12%) as was the intra-abdominal abscess rate (2% versus 6.0%). There were no deaths in either group. The overall morbidity was 4.5% for the LA group and 18% for the OA group. A clear tendency toward a shorter convalescence was seen in the LA group. CONCLUSIONS: LA is a safe and viable treatment alternative for acute appendicitis. Prospective randomized studies are needed to confirm its potential advantages.