Resumen

HILAIRE, Romel; RODRIGUEZ FERNANDEZ, Zenén; ROMERO GARCIA, Lázaro Ibrahim  y  RODRIGUEZ SANCHEZ, Luis Pablo. Laparoscopic versus conventional appendectomy. Rev Cubana Cir [online]. 2014, vol.53, n.1, pp. 30-40. ISSN 0034-7493.

Introduction: the systematic use of laparoscopic appendectomy to manage acute appendicitis is a controversial issue nowadays. Methods: a descriptive study of 720 patients with histopathological diagnosis of acute appendicitis, who had been operated on under emergency circumstances at the general surgery service of "Saturnino Lora"provincial university hospital in Santiago de Cuba from 2007 to 2009. The sample included 458 patients operated on by the laparoscopic appendectomy and 262 by conventional laparotomy. Results: males aged 21-30 prevailed, with preoperative physical exam of ASA II and histopathological diagnosis of supurative appendicitis. In both ways of access, the preoperative progression of disease ranged 24 to 48 h, the surgical time was 30 to 60 minutes and the length of stay at hospital ranged 4 to 7 days. The average of length of stay was 4.6 for laparoscopic appendectomy and 5.4 for conventional laparotomy. The percentage of complications in laparotomy-operated patients doubled that of the laparoscopic appendectomy, the surgical site infections prevailed in the former and the intra-abdominal abscesses were present in equal proportion in both ways of access. The conversion index reached 5.7%. Only one laparotomy-operated patient died from generalized sepsis. Conclusions: systematic laparoscopic appendectomy is a safe procedure to treat acute appendicitis in any phase of progression of this morbid process since it brings low postoperative morbidity and short length of stay at hospital.

Palabras clave : acute abdomen; appendicitis; appendectomy; surgical treatment; conventional surgery; laparoscopic surgery; emergency medical services; secondary health care.

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