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Revista Med
Print version ISSN 0121-5256On-line version ISSN 1909-7700
Abstract
HAZBON N., HÉCTOR RENÉ. LAPAROSCOPIC APPENDECTOMY: OUTCOME OF 91 CASES. rev.fac.med [online]. 2008, vol.16, n.2, pp.170-175. ISSN 0121-5256.
Appendectomy has different surgical approaches at this moment and there is no consensus as to whether the traditional or the minimally invasive is more efficient and safer. Different groups defend their approaches and there are studies of diverse tendencies that can help us make decisions on how to approach this common pathology, reinforcing the formal training in our specialty. 91 cases of appendicitis in their different presentations were accumulated in this study to analyze their surgical handling, evolution and complications, with the variable common epidemiologies of the group. The non-complicated appendectomies had an average surgical time of 32 minutes, whereas in the ones with generalized peritonitis it was 79.3 minutes. The hospital stay of the non-complicated appendectomy patients was 0.79 days, whereas in the cases of generalized peritonitis it was 7 days. There was no mortality and the morbidity of medical reason was due to comorbidity unrelated to the appendicular inflammatory phenomenon; whereas the surgical morbidity was the appearance of intraabdominal abscesses in 2 patients, sepsis and extension to a right hemicolectomy in another patient, persistent vomiting in another patient and pointing out the absence of infection of the operative bed in the studied cases. Based on these findings we propose that the laparoscopic approach of the non-complicated appendix is feasible with equal or inferior morbidity to the one obtained in the conventional approach. The difficulty in obtaining good results obeys to the non-standardization of the procedure and the diverse training of the groups that perform these approaches.
Keywords : appendicitis; laparoscopy; peritonitis; abscess.