In those clinical settings where surgical expertise and equipment are available and affordable, diagnostic laparoscopy and LA (either in combination or separately) seem to have various advantages over OA. Some of the clinical effects of LA, however, are small and of limited clinical relevance. In spite of the mediocre quality of the available research data, we would generally recommend to use laparoscopy and LA in patients with suspected appendicitis unless laparoscopy itself is contraindicated or not feasible. Especially young female, obese, and employed patients seem to benefit from LA.
A comparative study between laparoscopic versus open appendicectomy in men.
One hundred men between the age of 15 and 65 admitted to Ain Shams Specialized Hospital and El Demerdash Hospital, Cairo, and to the Saudi German Hospital, Saudi Arabia between November 1998 and December 2000 were randomized to undergo either open or laparoscopic appendicectomy. Both groups were compared in terms of clinical parameters, duration of anaesthesia, operative time, duration of ileus and length of hospital stay. The histologic confirmation of appendicitis was present in 92% in both groups. Laparoscopic appendectomy required significantly longer anaesthetic time (78 minutes versus 51) and operating time (49 minutes versus 23) compared with open appendectomy. No significant difference was noticed between laparoscopic and open appendectomy groups in the recovery of bowel function (24 hours versus 21) and in the length of hospital stay (4.9 days versus 5.3). The result showed no significant advantages of laparoscopic appendectomy over open appendectomy for the treatment of male patients with suspected appendicitis.