Current trends in the management of acute appendicitis

Background  While laparoscopic appendectomy (LA) has become established in the diagnosis and treatment of acute appendicitis, its utilisation compared to open appendectomy (OA) is variable. Aim  To compare the utilisation and outcome of laparoscopic (LA) versus OA in an Irish regional hospital setting. Method  Retrospective review of OA and LA performed from 2003 to 2005. Results  Intention-to-treat analysis of 787 patients in this study revealed that 149 patients (19%) had LA and 638 patients (81%) had OA. Consultants were significantly more likely than trainees to undertake a LA (P < 0.0001). Twenty-two complications (2.8%) were recorded in the post-operative period. The overall negative appendectomy rate by histopathology was 17% with no significant difference between the rate in the LA group (19%) and the OA (17%) group. Conclusion  Mean length of stay and complication rate were comparable between the LA and OA groups.