ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023
Routine use of laparoscopic techniques in daily practice improves outcomes after appendectomy.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. 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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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.
- Abdominal drainage to prevent intraperitoneal abscess after appendectomy for complicated appendicitis.The Cochrane database of systematic reviews · 2025Pooled it
- Feasibility of single-port laparoscopic appendectomy for retrocecal appendicitis: A propensity score-matched study with multi-port laparoscopic appendectomy.World journal of gastrointestinal surgery · 2025Article
- A Hypothetical New Challenging Use for Indocyanine Green Fluorescence during Laparoscopic Appendectomy: A Mini-Series of Our Experience and Literary Review.Journal of clinical medicine · 2023Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAppendectomy is the most common emergency operation and is often performed during on-call hours, when surgeons with different sub-specialties and levels of experience in emergency surgery operate on patients. However, little is known about the safety of the procedure when operations are performed by surgeons not regularly using standard laparoscopic techniques. Here we aim to assess variation in outcomes in patients operated on by surgeons with different levels of experience in laparoscopic surgery. MATERIALS AND
methodsConsecutive patients undergoing appendectomy at Tampere University Hospital between September 1, 2014 and April 30, 2017 for acute appendicitis were included. The data were analyzed by level of experience among surgeons regularly performing laparoscopic surgery and by volume among surgeons performing over 30 appendectomies per year or fewer.
resultsA total of 1560 patients underwent appendectomy, with 61% operated on by laparoscopic surgeons, and the rest by surgeons not habitually using laparoscopic techniques. Demographic characteristics, as well as share of patients with perforated appendicitis were similar in both groups. Morbidity was higher among those operated on by non-laparoscopic surgeons (6.1% and 3.0% p = 0.004), especially if appendicitis was complicated (18% and 5.6%, p < 0.001). Infectious complications were the most common. The risk of postoperative organ/space surgical site infections was higher among patients operated on by non-laparoscopic surgeons (3.5% vs. 1.4%, p = 0.006; Clavien-Dindo III-IV 2.0% vs. 0.7%, p = 0.030). Morbidity was 2.7% among those operated on by surgeons performing ≥ 30 appendectomies per year compared to 5.2% among those performing < 30 appendectomies per year. In multivariate analysis surgeon's experience (p = 0.002; HR 2.32, 95% CI 1.38-3.90) and complicated disease (p < 0.001; HR 4.71; 95% CI 2.79-7.93) predicted higher morbidity. DISCUSSION: According to our study, routine use of laparoscopic techniques in daily practice improves outcomes after appendectomy. In addition, a higher surgical volume correlates with improved outcomes.
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