2019 Volume 39 Issue 4 Pages 655-661
The value of open interval appendectomy for appendicular abscesses has long been debated. Laparoscopic interval appendectomy (LIA) for appendicular abscesses was first reported in the early 2000s and has been widely performed recently. However, only a few small retrospective studies have focused on the clinical results of LIA compared to laparoscopic emergency appendectomy (LEA). In the present study, we compared the results of LIA following conservative treatment versus LEA. We retrospectively reviewed the medical records of 68 patients with an appendicular abscess who underwent LIA or LEA from January 2007 to December 2016 at the Department of Gastroenterological Surgery at Ishikawa Prefectural Central Hospital. We performed 1 : 1 propensity score matching (PSM) between the LIA and LEA groups. In total, 62 patients were included the analysis. After PSM, demographic, clinical and abscess characteristics were similar and not statistically different between the 31 LIA and the 31 LEA patients. The operative time and amount of intraoperative bleeding were similar between the groups. The rate of conversion to open surgery or ileocecal resection was relatively lower among LIA patients (3.2％ vs. 22.6％; P=0.08). Patients undergoing LIA experienced fewer postoperative complications (0％ vs 25.8％; P=0.01) and a shorter postoperative hospital stay (4 [3–5]days vs. 7 [5–8] days; P＝0.007） compared to LEA patients. The total hospital stay that included a conservative treatment period was significantly longer in LIA patients (16 [12–18] days vs. 8 [6–10] days, P＝0.00009). The results of the present study demonstrated that LIA had fewer postoperative complications and a shorter postoperative hospital stay than LEA.
