Laparoscopische behandeling van appendicitis acuta: minder pijn en wondinfecties, maar langere operatietijd; een gerandomiseerd onderzoek

Comparison of efficacy and morbidity of laparoscopic and conventional appendectomy.

Design

Randomized clinical trial.

Setting

St. Clara Hospital Rotterdam, University Hospital Rotterdam Dijkzigt, Rotterdam, the Netherlands.

Methods

Patients with suspected acute appendicitis were randomized either for laparoscopic or conventional appendectomy. Operating time, operative findings, postoperative pain and complications and hospital stay were recorded. Analysis was by ‘intention-to-treat’.

Results

Conventional appendectomy was performed in 104, laparoscopic appendectomy in 97 patients. Conventional appendectomy required less operating time (42 versus 61 min, p < 0.001). Patients after conventional appendectomy had more pain (p < 0.001) and a higher need of analgetics (p < 0.005). Wound infection occurred more frequently after conventional appendectomy (p < 0.001). Hospital stay was similar in both groups (mean 4.4 versus 3.7 days).

Conclusion

Laparoscopic appendectomy was associated with less postoperative pain and a lower incidence of wound infection but requires more operating time.