Comparison of Laparoscopic and Open Surgery for Appendiceal Mucocele in Terms of Safety and Feasibility.

Objectives: Appendiceal mucocele (AM) is a rare clinicopathological entity, and the optimal surgical approach remains controversial because of concerns regarding intraoperative rupture and mucin spillage. This study aimed to compare laparoscopic surgery (LS) and open surgery (OS) in patients with AM in terms of perioperative safety, postoperative recovery, and pathological outcomes. Methods: This retrospective single-center study included 53 patients who underwent surgery for AM between January 2010 and January 2026. Patients were divided into LS and OS groups. Demographic and clinical characteristics, operative findings, postoperative outcomes, and histopathological results were compared between the groups. Results: Of the 53 patients, 20 underwent LS and 33 underwent OS. Baseline clinical characteristics were generally comparable between the groups, although female sex was more frequent in the LS group. Operative time, surgical procedure distribution, intraoperative perforation findings, intraoperative mucocele rupture, Clavien-Dindo scores, morbidity, readmission, and reoperation rates were not significantly different between the groups. LS was associated with earlier return of bowel function, earlier tolerance of a soft diet, and shorter postoperative hospital stay. Low-grade appendiceal mucinous neoplasm was the most common histopathological diagnosis, and pathological diagnosis distribution and surgical margin positivity were comparable between the groups. Conclusion: LS may be considered a safe and feasible alternative to OS in selected patients with AM, providing comparable perioperative and pathological outcomes with more favorable short-term postoperative recovery. Careful patient selection, meticulous surgical technique, and readiness for conversion remain essential.