PROSPECTIVE NONRANDOMIZED STUDY OF CONVENTIONAL VERSUS LAPAROSCOPIC APPENDECTOMY

With the introduction of laparoscopic appendectomy a prospective study was started. Patients with suspected appendicitis were selected for c onventional appendectomy or laparoscopy according to the preference of the surgeon on calf. During a 1-year period 233 patients were include d, of whom 97 underwent conventional appendectomy and 136 laparoscopy. Among the patients selected to laparoscopy, laparoscopic appendectomy was carried out in 72 eases, conventional appendectomy in 32, and onl y diagnostic laparoscopy in the remaining 32. Removal of a normal appe ndix was significantly more common in the group of patients directly s elected for conventional appendectomy compared to laparoscopy (p < 0.0 1). The duration of the operation was shorter (p < 0.05) and the posto perative hospital stay and the convalescence longer (p < 0.05) with co nventional than with laparoscopic appendectomy. Peroperative problems and minor postoperative complications were more common (p < 0.01) with laparoscopic than conventional appendectomy. However, the clinical im pact of these problems were limited. The difference between the proced ures regarding major complications was not significant. Laparoscopic a ppendectomy seems to be at least as good as conventional appendectomy. However, randomized controlled trials are needed to decide which of t he procedures to recommend.