Laparoscopic Versus Open Appendectomy: Prospective Randomized Trial

Laparosopic appendectomy is feasible, but whether it confers any advantage to patients with acute appendicitis is not cleary know, A prospective randomized trial comparing laproscopic appendectomy (LAP) with open appendectomy (OAP) in patients with a presumed diagnosis of acute appendicitis with or without various degrees of complications was conducted between January 1, 1994 and September 30, 1994. Seventy consecutive patients were randomized, 30 to LAP and 40 to OAP including two laparotomy patients in OAP group for diffuse peritonitis. When compared to OAP, LAP had longer operative time(102.5±37.18 vs 84±35.54 min), less requirement for analgesia (0.76±1.59 vs1.32±1.42 dose), earlier oral intake (2.13±1.22 vs 3.02 ± 1.42 day), fewer wound infection (0% vs 20%), shorter hospital stay (5.06±3.02 vs 6.91±4.42 day )and quicker recovery to normal activity (12±7 vs 19±9 day). The similar results were also found in cases with ruptured appendicitis and obesity. Despite of longer but acceptable operative time for LAP, it provides the advantages as mentioned above. Therefore it should be considered a worthwhile alternative for patients with clinical diagnosis of acute appendicitis and might also play a considerable role in patients with ruptured appendicitis and obesity.