Therapeutic Approaches for Acute Appendicitis

Abstract

Aim: The aim of this study was to evaluate the outcome of laparoscopic appendectomy (LA) versus single incision laparoscopic appendectomy in patients with appendicitis, and to show the standard treatment of acute appendicitis in our hospital. Methods: We retrospectively analyzed the clinical records of 1280 patients who had undergone laparoscopic appendectomy for appendicitis between May 1995 and Dec 2011. (Study 1): We compared results between 447 patients who underwent LA and 72 patients who had single incision laparoscopic appendectomy. (Study 2): We analyzed 40 patients treated conservatively at the hospital without the need for emergency surgery. Results: (Study 1): Patient demographics were similar in the LA and single incision LA groups. The operating time was significantly longer in the LA group at 75.0±35.0 minutes than in the single incision LA group at 66.7±25.6 min (p<0.05). The intra/postoperative course did not differ significantly between the two groups. (Study 2): In the patients who chose conservative treatment, in 16 patients the WBC counts were less than 10,000/mm³, and swelling of the appendix was less than 10mm in 12 patients. Hospitalization was 5.3 days. There were no patients who needed surgery during hospitalization. Conclusions: Our findings indicate that single incision LA is safe and useful when compared to LA in treating uncomplicated appendicitis, and these results suggest that our treatment strategy is reasonable.