LAPAROSCOPIC VERSUS OPEN APPENDECTOMY - A PROSPECTIVE RANDOMIZED TRIAL OF 81 PATIENTS

OBJECTIVE: To compare the efficacy of laparoscopic appendectomy (LA) a nd open appendectomy (OA) in the treatment of acute appendicitis. DESI GN: A prospective randomized trial. SETTING: A university teaching hos pital. PATIENTS: Eighty-one patients with a diagnosis of acute appendi citis were prospectively randomized to undergo either LA or OA. The tw o groups were matched for age and sex. INTERVENTIONS: LA or OA. MAIN O UTCOME MEASURES: Number of days in hospital and time to full recovery. RESULTS: The mean hospital stay for LA was 3.23 days compared with 3. 03 days for OA (p < 0.001). The mean number of narcotic injections req uired for patients in the LA group was 4.05 compared with 5.58 for pat ients in the OA group (p < 0.001). The mean time to complete recovery for patients in the LA group was 9.0 days compared with 16.2 days for patients in the OA group (p < 0.001). The mean operative time for LA w as 73.8 minutes compared with 45.0 minutes for OA (p < 0.001). Three p atients in the LA group had intra-abdominal abscesses (p > 0.25). No s ignificant difference in wound infection rates was demonstrated (p > 0 .05). Similarly, pain scores at 7 and 28 days showed no significant di fferent (p > 0.05). CONCLUSIONS: With LA significantly fewer narcotic injections are required and there is a more rapid return to normal act ivities. LA takes longer to perform and was associated with three intr a-abdominal abscesses. In cases of simple acute appendicitis the hospi tal stay for LA is significantly shorter.