Conventional versus laparoscopic surgery for acute appendicitis
A total of 155 consecutive patients with suspected acute appendicitis were studied to compare laparoscopic and conventional operations. Patients were not randomized: laparoscopy was performed when a suitably trained surgeon and laparoscopic instruments were available. Laparoscopic appendicectomy was attempted in 51 patients and was successful in 46 (90 per cent); all conversions to open operation were because of marked injammatory adhesions around the appendix. There were no intraoperative complications. Reintroduction of normal diet and discharge from hospital occurred earlier after laparoscopic than open surgery ( P < 0-05). The requirement f o r analgesia after successful laparoscopic surgery was less than that after conventional appendicectomy, but the difference was not signifcant. The incidence of wound infection was reduced after the laparoscopic procedure (P = 0.06). It is concluded that laparoscopic appendicectomy is practical and may have advantages over conventional operation, although a randomized study is necessary.
Laparoscopic appendicectomy was first described by Semm1~2 in 1982, but until recently was popular in only a few centre^^.^.
However, the widespread introduction of laparoscopic surgery for gallstones has rekindled interest in the procedure. The major advantages of laparoscopic cholecystectomy are fewer complications and earlier r e ~o v e r y ~-~, although these are so dramatic that it has become difficult to perform comparative trials'. Hence the question arises whether the same benefits are available from laparoscopic appendicectomy.
The present study describes a series of appendicectomy operations performed during the 6-month period after the introduction of laparoscopic appendicectomy at this hospital. The aim was to assess the practicality of laparoscopic appendicectomy and to compare the results with those of the conventional operation.