Laparoscopic appendectomy safer than open surgery for patients of acute appendicitis
China: Laparoscopic appendectomy (LA) is a safe and feasible procedure for the treatment of patients with acute appendicitis (AA), a recent study in the World Journal of Emergency Surgery has stated.
The meta-analysis found that laparoscopic appendectomy compared to open appendectomy (OA) was advantageous in terms of fewer adverse reactions, fewer complications, shorter operation time and hospitalization, and lower inflammatory response.
Guangzhe Zhang & Bo Wu from The First Hospital of China Medical University, Shenyang, Liaoning, China compared the postoperative recovery of patients with acute appendicitis after laparoscopic appendectomy and open appendectomy and aimed to determine the optimal diagnosis and treatment plan for appendectomy.
For this purpose, the researchers searched the online databases for the related literature. To extract data, articles on LA and OA for AA published between 2010 and 2021 were selected. Stata16.0 was used for meta-analysis.
Based on the study, the researchers reported the following findings:
· A total of 777 articles were retrieved, and 16 of them were finally selected. Totally, 1251 patients underwent LA, while 898 patients received OA.
· According to the results of the meta-analysis, LA was associated with a lower incidence of adverse reactions [OR = 0.257], shorter operation time (SMD = − 1.802), and hospitalization (SMD = − 1.184).
· In addition, compared with the OA group, LA was found with less intraoperative blood loss (SMD = − 3.650) and shorter recovery time of gastrointestinal function (SMD = − 3.010).
· Aside from all these, the counts of leukocyte (SMD = − 0.432), neutrophil (SMD = − 1.346), and C-reactive protein (SMD = − 2.391) all decreased in a significant manner after LA.
"LA is advantageous in terms of having shorter operation times and hospital stays, fewer adverse reactions, lower inflammatory response, and fewer complications. Hence, it is safe and feasible surgery for AA," the authors wrote in their study.
"The study serves to fill the knowledge gap in the literature discussing the optimization of postoperative recovery by LA, and lays a solid theoretical basis for the development of clinical diagnosis and treatment plan for AA," they concluded.
Reference:
Zhang, G., Wu, B. Meta-analysis of the clinical efficacy of laparoscopic appendectomy in the treatment of acute appendicitis. World J Emerg Surg 17, 26 (2022). https://doi.org/10.1186/s13017-022-00431-1
