LAPAROSCOPIC APPENDECTOMY DOES NOT CHANGE THE INCIDENCE OF POSTOPERATIVE INFECTIOUS COMPLICATIONS

BACKGROUND: If is not clear whether the laparoscopic approach does dec rease the incidence of postoperative infectious complications after ap pendectomy. METHODS: One hundred sixty-nine patients were randomized, 87 with laparoscopic (LA) and 82 with open appendectomy (OA). Patients in the OA group had a McBurney incision; LA was performed in the lith otomy position. RESULTS: Acute appendicitis was confirmed in 75% of pa tients. The appendix was perforated in 5 patients of the LA versus 2 p atients of the OA group. No conversion to the open procedure was neces sary. The median operating time was 35 minutes in the LA group and 31 minutes in the open group (P = 0.58). The median postoperative hospita l stay was shorter after laparoscopic than after open surgery (3 days versus 4 days, P = 0.026), whereas the time required for return to wor k was not significantly different (14 versus 15 days). There were 5 (6 %) patients with superficial wound infection following LA and 6 (7%) a fter OA (P = 0.67). Intra-abdominal fluid collections were found in 2 (2%) patients following LA and 3 (4%) patients following OA (P = 0.60) . In the LA group, 3 patients presented with intra-abdominal hemorrhag e and another 3 developed a paralytic ileus that was treated conservat ively. CONCLUSIONS: Laparoscopic appendectomy is as safe and as effect ive as the open procedure; however, it does not decrease the rate of p ostoperative infectious complications. (C) 1998 by Excerpta Medica, In c.