ArticleWorld journal of surgery2022
Trends in Adoption of Laparoscopic Appendicectomy in a Developing Country: Closing the Gap.
Article in World journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Pulmonary recruitment maneuver reduces the intensity of post-laparoscopic shoulder pain: a systematic review and meta-analysis.BMC anesthesiology · 2023Pooled it
- Minimally Invasive Surgical Techniques in the Treatment of Appendicitis: A Narrative Review.Cureus · 2025Review
- Laparoscopic appendectomy improves outcomes and reduces costs in rural Kenya.Surgical endoscopy · 2025Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study reviews our use of laparoscopic versus open appendicectomy over the last decade to track the trends in their usage in a middle-income country.
methodsA retrospective study was conducted on patients with intraoperative confirmed acute appendicitis from January 2013 to December 2019 at Grey's Hospital, Pietermaritzburg, South Africa.
resultsEight hundred fifty-one cases of AA were included. 724 (85%) patients underwent open surgery; 435 (60%) via a midline incision and 194 (27%) via a local incision. 127 (15%) patients underwent laparoscopic appendicectomy. A significant rend was noted for an increasing proportion of surgery performed by laparoscopy compared to open surgery (p = 0.02). Patients who underwent open surgery compared to laparoscopy presented with greater peritonism (48.5% vs. 28%, p < 0.001), delay from symptom onset (3 vs. 2 days, p < 0.001), more frequently from rural areas (94% vs. 86%, p = 0.002) and with higher AAST scores (46.7% AAST ≥ 4, vs. 14.9%, p < 0.001). This former group had significantly greater morbidity (42% vs. 35%, p < 0.001) with higher Clavien-Dindo scores, were more likely to require ICU admission (8.3% vs. 2.3%, p < 0.001) and have longer hospital stay (4 days vs. 2 days, p < 0.001); no statistically significant difference in mortality was observed (1.1% vs. 0.8%, p = 0.75).
conclusionsThere has been a steady increase in the uptake of laparoscopic appendicectomy and decrease in open approaches in our centre. There is still a high rate of patients with advanced disease, and it is unlikely that this cohort will be suitable for laparoscopic surgery. If we hope to increase the uptake of laparoscopic surgery for acute appendicitis even further, we must focus on identifying patients with early and low-grade disease.
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