SynthesisSurgical endoscopy2019
Laparoscopic appendicectomy is superior to open surgery for complicated appendicitis.
Synthesis in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Surgical outcomes of emergency open appendectomy for acute appendicitis: an audit of 2268 patients in a single center.Nagoya journal of medical science · 2025Article
- Application value of the vertical and horizontal hierarchical responsibility management nursing model in patients undergoing appendectomy.Frontiers in surgery · 2025Article
- Analysis of risk factors associated with the development and postoperative complications of complicated acute appendicitis in elderly patients.Frontiers in surgery · 2025Article
- Usefulness of laparoscopic surgery for colorectal perforation: a single-center retrospective cohort study.Surgery today · 2024Article
- Article
- Postoperative Complications Following Appendectomy: A Single-Center Retrospective Study.Cureus · 2024Article
- Early versus delayed appendicectomy for appendiceal phlegmon or abscess.The Cochrane database of systematic reviews · 2024Review
- Retrospective analysis of the incidence of appendiceal neoplasm and malignancy in patients treated for suspected acute appendicitis.BMC surgery · 2024Article
- Acute Appendicitis Treatment Strategies and Mortality Based on Critical Illness on Admission: An Observational Study.Surgical infections · 2024Observational
- The Outcome of Laparoscopic Versus Open Appendectomy in Childhood.Deutsches Arzteblatt international · 2024Article
- Comparative study of video recordings of non-medical devices in laparoscopic surgery: a cross-sectional study.Surgical endoscopy · 2023Article
- Article
- Article
- Evaluation of the Appropriate LigaSure™ Device to Transect the Appendix-A Comparison between 5 mm and 10 mm Laparoscopic Devices in an Ex Vivo Trial.Medicina (Kaunas, Lithuania) · 2023Article
- Article
- Risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis.Annals of coloproctology · 2023Article
- Application and curative effect of laparoscopic purse-string sutures in the treatment of adult acute complicated appendicitis.BMC surgery · 2023Article
- Challenges to implement laparoscopic appendectomy as the first-line treatment for acute appendicitis: a fifteen-year experience in a tertiary hospital in Brazil.Revista do Colegio Brasileiro de Cirurgioes · 2023Article
- Colonoscopic titanium clipping to Maddress appendiceal stump leakage: a case report.Frontiers in surgery · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOver the last three decades, laparoscopic appendicectomy (LA) has become the routine treatment for uncomplicated acute appendicitis. The role of laparoscopic surgery for complicated appendicitis (gangrenous and/or perforated) remains controversial due to concerns of an increased incidence of post-operative intra-abdominal abscesses (IAA) in LA compared to open appendicectomy (OA). The aim of this study was to compare the outcomes of LA versus OA for complicated appendicitis.
methodsA systematic literature search following PRISMA guidelines was conducted using MEDLINE, EMBASE, PubMed and Cochrane Database for randomised controlled trials (RCT) and case-control studies (CCS) that compared LA with OA for complicated appendicitis.
resultsData from three RCT and 30 CCS on 6428 patients (OA 3,254, LA 3,174) were analysed. There was no significant difference in the rate of IAA (LA = 6.1% vs. OA = 4.6%; OR = 1.02, 95% CI = 0.71-1.47, p = 0.91). LA for complicated appendicitis has decreased overall post-operative morbidity (LA = 15.5% vs. OA = 22.7%; OR = 0.43, 95% CI: 0.31-0.59, p < 0.0001), wound infection, (LA = 4.7% vs. OA = 12.8%; OR = 0.26, 95% CI: 0.19-0.36, p < 0.001), respiratory complications (LA = 1.8% vs. OA = 6.4%; OR = 0.25, 95% CI: 0.13-0.49, p < 0.001), post-operative ileus/small bowel obstruction (LA = 3.1% vs. OA = 3.6%; OR = 0.65, 95% CI: 0.42-1.0, p = 0.048) and mortality rate (LA = 0% vs. OA = 0.4%; OR = 0.15, 95% CI: 0.04-0.61, p = 0.008). LA has a significantly shorter hospital stay (6.4 days vs. 8.9 days, p = 0.02) and earlier resumption of solid food (2.7 days vs. 3.7 days, p = 0.03).
conclusionThese results clearly demonstrate that LA for complicated appendicitis has the same incidence of IAA but a significantly reduced morbidity, mortality and length of hospital stay compared with OA. The finding of complicated appendicitis at laparoscopy is not an indication for conversion to open surgery. LA should be the preferred treatment for patients with complicated appendicitis.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.