CLINICAL STUDY ON THE USEFULNESS OF LAPAROSCOPIC APPENDECTOMY

The usefulness of laparoscopic appendectomy (LA) was studied in terms of its need assessment based on exploratory therapeutic results and a questionnaire survey. Subjects were 62 cases undergone LA at the hospital from October 1997 to August 1999. Their ages ranged from 7 to 81 years. LA using three...

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Published inNihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 61; no. 7; pp. 1680 - 1685
Main Authors TAKASE, Yasuhiro, SHIBUYA, Susumu, CHIKAMORI, Fumio
Format Journal Article
LanguageEnglish
Published Japan Surgical Association 2000
Online AccessGet full text
ISSN1345-2843
1882-5133
1882-5133
DOI10.3919/jjsa.61.1680

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Abstract The usefulness of laparoscopic appendectomy (LA) was studied in terms of its need assessment based on exploratory therapeutic results and a questionnaire survey. Subjects were 62 cases undergone LA at the hospital from October 1997 to August 1999. Their ages ranged from 7 to 81 years. LA using three trocars was employed, and a 10/12mm trocar to the umbilical region, a 5/7mm trocar to the right flank, and a 5/7mm trocar to the superior extremity of the pubis were inserted. Mesentery and the root of the appendix were ligated in the body with 1-0 silk thread, and then the appendix was resected by mean of ultrasonic coagulotomy. As a result, the ratio of converting to laparotomy was 3.2%. Mean operating times were 98±38 min (n=15) in gangrenous appendicitis and 65±18 min (n=15) in non-gangrenous appendicitis (p<0.01). Complications included bleeding at the sites of inserting trocars in one case and intraabdominal abscess in one case in the early time of the study. A questionnaire survey revealed that 89.0% of the subjects answered preferably to select LA than laparotomic appendectomy. It is concluded that LA is an established technique and is benificial in cosmetic merit as well as in the differential diagnosis of gynecological emergency disorders. In the explanation of operative procedures for appendectomy, we must explain LA to pay respect to the patient's right to choice the therapeutic method.
AbstractList The usefulness of laparoscopic appendectomy (LA) was studied in terms of its need assessment based on exploratory therapeutic results and a questionnaire survey. Subjects were 62 cases undergone LA at the hospital from October 1997 to August 1999. Their ages ranged from 7 to 81 years. LA using three trocars was employed, and a 10/12mm trocar to the umbilical region, a 5/7mm trocar to the right flank, and a 5/7mm trocar to the superior extremity of the pubis were inserted. Mesentery and the root of the appendix were ligated in the body with 1-0 silk thread, and then the appendix was resected by mean of ultrasonic coagulotomy. As a result, the ratio of converting to laparotomy was 3.2%. Mean operating times were 98±38 min (n=15) in gangrenous appendicitis and 65±18 min (n=15) in non-gangrenous appendicitis (p<0.01). Complications included bleeding at the sites of inserting trocars in one case and intraabdominal abscess in one case in the early time of the study. A questionnaire survey revealed that 89.0% of the subjects answered preferably to select LA than laparotomic appendectomy. It is concluded that LA is an established technique and is benificial in cosmetic merit as well as in the differential diagnosis of gynecological emergency disorders. In the explanation of operative procedures for appendectomy, we must explain LA to pay respect to the patient's right to choice the therapeutic method.
Author SHIBUYA, Susumu
TAKASE, Yasuhiro
CHIKAMORI, Fumio
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References 8) Hansen JB, Smithers BM, Schanche D, et al: Laparoscopic versus open appendectomy: Prospective randomized trial. World J Surg 20: 17-21, 1996
13) Tate JJT, Dawson JW, Chung SCS, et al: Laparoscopic versus open appendectomy: a prospective randomized trial. Lancet 342: 633-637, 1999
12) Palavesa MMFdela, Vaxmann D, Campos M, et al: Appendiceal stump abscess. Abdom Imaging 21: 65-66, 1996
1) Semm K: Endoscopic appendectomy. Endoscopy 15: 59-64, 1983
5) Richards KF, Fisher KS, Flores JH, et al: Laparoscopic appendectomy: Comparison with open appendectomy in 720 patients. Surgical Laparoscopy & Endoscopy 3: 205-209, 1996
11) Minne L, Varner D, Burnell A, et al: Laparoscopic vs open appendectomy. Prospective randomized study of outcomes. Arch Surg 132: 708-711, 1997
3) Johnson AB, Peetz ME: Laparoscopic appendectomy is an acceptable alternative for the treatment of perforated appendicitis. Surg Endosc 12: 940-943, 1998
4) Panton ON, Samson C, Segal J, et al: A four-year experience with laparoscopy in the management of appendicitis. Am J Surg 171: 538-541, 1996
10) Chiarugi M, Buccianti P, Celona G, et al: Laparoscopic compared with open appendectomy for acute appendicitis: a prospective study. Eur J Surg 385-390, 1996
6) Macarulla E, Vallet J, Abad JM, et al: Laparoscopic versus open appendectomy: a prospective randomized trial. Surgical Laparoscopy & Endoscopy 7: 335-339, 1997
7) Laine S, Rantala A, Gullichsen R, et al: Laparoscopic appendectomy is it worthwhile? Surg Endosc 11: 95-97, 1997
2) Golub R, Siddiqui F, Pohl D: Laparoscopic versus open appendectomy: A meta-analysis. J Am Coll Surg 186: 545-553, 1998
9) Kazemier G, Zeeuw GRde, Lange JF, et al: Laparoscopic vs open appendectomy. Surg Endosc 11: 336-340, 1997
14) Attwood S, Hill A, Murphy P, et al: A prospective randomized trial of laparoscopic versus open appendectomy. Surgery 112: 497-501, 1992
References_xml – reference: 4) Panton ON, Samson C, Segal J, et al: A four-year experience with laparoscopy in the management of appendicitis. Am J Surg 171: 538-541, 1996
– reference: 2) Golub R, Siddiqui F, Pohl D: Laparoscopic versus open appendectomy: A meta-analysis. J Am Coll Surg 186: 545-553, 1998
– reference: 1) Semm K: Endoscopic appendectomy. Endoscopy 15: 59-64, 1983
– reference: 6) Macarulla E, Vallet J, Abad JM, et al: Laparoscopic versus open appendectomy: a prospective randomized trial. Surgical Laparoscopy & Endoscopy 7: 335-339, 1997
– reference: 8) Hansen JB, Smithers BM, Schanche D, et al: Laparoscopic versus open appendectomy: Prospective randomized trial. World J Surg 20: 17-21, 1996
– reference: 11) Minne L, Varner D, Burnell A, et al: Laparoscopic vs open appendectomy. Prospective randomized study of outcomes. Arch Surg 132: 708-711, 1997
– reference: 10) Chiarugi M, Buccianti P, Celona G, et al: Laparoscopic compared with open appendectomy for acute appendicitis: a prospective study. Eur J Surg 385-390, 1996
– reference: 5) Richards KF, Fisher KS, Flores JH, et al: Laparoscopic appendectomy: Comparison with open appendectomy in 720 patients. Surgical Laparoscopy & Endoscopy 3: 205-209, 1996
– reference: 12) Palavesa MMFdela, Vaxmann D, Campos M, et al: Appendiceal stump abscess. Abdom Imaging 21: 65-66, 1996
– reference: 7) Laine S, Rantala A, Gullichsen R, et al: Laparoscopic appendectomy is it worthwhile? Surg Endosc 11: 95-97, 1997
– reference: 9) Kazemier G, Zeeuw GRde, Lange JF, et al: Laparoscopic vs open appendectomy. Surg Endosc 11: 336-340, 1997
– reference: 14) Attwood S, Hill A, Murphy P, et al: A prospective randomized trial of laparoscopic versus open appendectomy. Surgery 112: 497-501, 1992
– reference: 3) Johnson AB, Peetz ME: Laparoscopic appendectomy is an acceptable alternative for the treatment of perforated appendicitis. Surg Endosc 12: 940-943, 1998
– reference: 13) Tate JJT, Dawson JW, Chung SCS, et al: Laparoscopic versus open appendectomy: a prospective randomized trial. Lancet 342: 633-637, 1999
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