Laparoscopic vs conventional appendectomy for suspected acute appendicitis
Ferrante D
Record ID 32005000617
Spanish
Authors' objectives:
The aim of this report was to summarise the available evidence on laparoscopic vs conventional appendectomy for suspected acute appendicitis.
Authors' results and conclusions:
To revise available evidence, randomized trials which compared 1) therapeutic effects in adults, 2) therapeutic effects in children, 3) diagnostic effects of laparoscopy followed by surgery (laparoscopic or conventional) vs immediate conventional surgery and 4) therapeutic effects of diagnostic laparoscopy followed by open surgery vs immediate conventional surgery were included. Only randomized with blinded assignment studies were included. Fifty one studies of laparoscopic surgery (LS) vs conventional surgery (CS) (42 in adults) were considered. Wound infections were less frequent in LS (OR 0.47), but the incidence of intra-abdominal abscesses was higher (OR 2.77). LS presented (difference with CS): longer surgical time (14 minutes), less pain, shorter hospital stay (0.7 days), shorter return to normal activity (6 days) , higher intra-hospital costs but lower after discharge. In children similar results were observed. Diagnostic laparoscopy was associated with a decrease in negative appendectomies and unknown diagnosis. This effect was more evident in young women.
Authors' recommendations:
In those settings/institutions where experience and equipment are available, and there are resources, diagnostic laparoscopy and LS are recommended according to clinical guidelines, although some of the effects of laparoscopic appendectomy (LA) are small and of little clinical relevance and that the evidence is of poor quality. In cases when perforation or gangrenous appendicitis is suspected, however, LS can be associated with higher risk of intra-abdominal infections.
Authors' methods:
Economic evaluation
Details
Project Status:
Completed
URL for project:
http://www.iecs.org.ar/
Year Published:
2003
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Argentina
MeSH Terms
- Comparative Study
- Treatment Outcome
- Appendectomy
- Appendicitis
- Laparoscopy
- Microsurgery
Contact
Organisation Name:
Institute for Clinical Effectiveness and Health Policy
Contact Address:
Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name:
info@iecs.org.ar
Contact Email:
info@iecs.org.ar
Copyright:
Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.