The need for crossover in management and recurrent appendicitis were low among all studies .
For those patients who ultimately required surgery , no increased complications were observed .
Antibiotics may be safely recommended in patients with high surgical risk , such as the elderly or those with multiple comorbidities
AIM To review outcomes of  surgical and antibiotic management of acute appendicitis .
Improving Outcomes After Laparoscopic Appendectomy: A Population-Based, 12-year Trend Analysis of 7446 Patients
OBJECTIVE Laparoscopic appendectomy for acute appendicitis has become increasingly used over the past decade . The objective of this trend analysis is to assess whether clinical outcomes after laparoscopic appendectomy have improved over the past 12 years . METHODS This analysis is based on the prospect i ve data base of the Swiss Association of Laparoscopic and Thoracoscopic Surgery . All patients undergoing emergency laparoscopic appendectomy for acute appendicitis from 1995 to 2006 were included . The following outcomes were assessed for each of the 12 years : conversion rates , intraoperative complications , surgical postoperative complications , general postoperative complications , rate of reoperations , and length of hospital stay . Unadjusted and risk-adjusted multivariable analyses were performed . Statistical significance was set at a level of P < 0.05 . All statistical tests were 2-sided . RESULTS Data from 7446 patients undergoing laparoscopic appendectomy for acute appendicitis were prospect ively collected . Over the period of observation , the conversion rate decreased significantly from 2.2 % to 1.2 % ( P(trend ) < 0.001 ) , as did intraoperative complications ( from 3.1 % to 0.7 % ; P(trend ) < 0.001 ) , surgical postoperative complications ( from 6.1 % to 1.9 % ; P(trend ) < 0.001 ) , general postoperative complications ( from 4.9 % to 1.5 % ; P(trend ) < 0.001 ) , and rates of reoperations ( from 3.4 % to 0.7 % ; P(trend ) < 0.001 ) . Average postoperative length of hospital stay also significantly decreased from 4.9 to 3.5 days ( P(trend ) < 0.001 ) . CONCLUSIONS Our investigation provides compelling evidence that intraoperative complications , surgical and general postoperative complications , conversion rates , rates of reoperations , and average length of hospital stay have significantly decreased over the past decade in patients undergoing surgery for acute appendicitis . The present trend analysis is the first one in the literature encompassing more than a decade and reporting clinical outcomes after laparoscopic appendectomy for acute appendicitis , which represents an important quality control
The need for crossover in management and recurrent appendicitis were low among all studies .
For those patients who ultimately required surgery , no increased complications were observed .
Antibiotics may be safely recommended in patients with high surgical risk , such as the elderly or those with multiple comorbidities
AIM To review outcomes of  surgical and antibiotic management of acute appendicitis .