Does Laparoscopic Appendectomy Impart an Advantage over Open Appendectomy in Elderly Patients?

Masoomi, Hossein; Mills, Steven; Dolich, Matthew; Ketana, Noor; Carmichael, Joseph; Nguyen, Ninh; Stamos, Michael
July 2012
World Journal of Surgery;Jul2012, Vol. 36 Issue 7, p1534
Academic Journal
Background: The use of laparoscopy in the elderly has been increasing in recent years. The data comparing laparoscopic (LA) with open appendectomy (OA) in elderly patients are minimal. We evaluated outcomes of LA versus OA in perforated and nonperforated appendicitis in elderly patients (aged ≥65 years). Methods: Using the Nationwide Inpatient Sample database, clinical data of elderly patients who underwent LA and OA for suspected acute appendicitis were evaluated from 2006 to 2008. Results: A total of 65,464 elderly patients underwent urgent appendectomy during this period. The rate of perforated appendicitis was twice as high in elderly patients (50 vs. 25%, p < 0.01) and rate of LA in elderly patients was lower (52 vs. 63%, p < 0.01) compared with patients younger than aged 65 years. Utilization of LA increased 24% from 46.5% in 2006 to 57.8% in 2008 ( p < 0.01). In elderly patients with acute nonperforated appendicitis, LA had lower overall complication rate (15.82 vs. 23.49%, p < 0.01), in-hospital mortality (0.39 vs. 1.31%, p < 0.01), hospital charges ($30,414 vs. $34,095, p < 0.01), and mean length of stay (3.0 vs. 4.8 days, p < 0.01) compared with OA. Additionally, in perforated appendicitis in elderly patients, LA was associated with lower overall complication rate (36.27 vs. 46.92%, p < 0.01), in-hospital mortality (1.4 vs. 2.63%, p < 0.01), mean hospital charges ($43,339 vs. $57,943, p < 0.01), and shorter mean LOS (5.8 vs. 8.7 days, p < 0.01). Conclusions: Laparoscopic appendectomy can be performed safely with significant advantages compared with open appendectomy in the elderly and should be considered the procedure of choice for perforated and nonperforated appendicitis in these patients.


Related Articles

  • Subhepatic appendicitis presenting with right upper quadrant pain. Kirresh, Othman Z.; Nikolopoulos, Ioannis; Oke, Tayo; Koshy, Susan // British Journal of Hospital Medicine (17508460);Oct2012, Vol. 73 Issue 10, p593 

    Several photographs showing a computed tomography (CT) scan of the subhepatic appendicitis and a reconstruction showing a high appendix seen in the right upper quadrant.

  • Ideal Timing of Surgery for Acute Uncomplicated Appendicitis. Eko, Frederick N.; Ryb, Gabriel E.; Drager, Leslie; Goldwater, Eva; Wu, Jacqueline J.; Counihan, Timothy C. // North American Journal of Medical Sciences;Jan2013, Vol. 5 Issue 1, p22 

    Background: Early surgery for appendicitis is thought to avoid complications associated with appendiceal rupture. Aims: This study was to evaluate the effect of timing of surgery on complications, length of stay (LOS) and cost in patients undergoing appendectomy. Materials and Methods:...

  • Laparoscopic Appendectomy Trends and Outcomes in the United States: Data from the Nationwide Inpatient Sample (NIS), 2004-2022. MASOOMI, HOSSEIN; NGUYEN, NINH T.; DOLICH, MATTHEW O.; MILLS, STEVEN; CARMICHAEL, JOSEPH C.; STAMOS, MICHAEL J. // American Surgeon;Oct2014, Vol. 80 Issue 10, p1074 

    Laparoscopic appendectomy (LA) is becoming the standard procedure of choice for appendicitis. We aimed to evaluate the frequency and trends of LA for acute appendicitis in the United States and to compare outcomes of LA with open appendectomy (OA). Using the Nationwide Inpatient Sample database,...

  • Analyses approach: exploring the effect of emergency department interventions on outcomes of hospitalisation. Clark, Karen; Normile, Loretta // Nurse Researcher;2007, Vol. 15 Issue 1, p55 

    Karen Clark and Loretta Normile describe the approach of analysis of variables for outcomes research. The purpose of the study was to explore the effects of interventions in the emergency department on outcomes of hospitalisation for cases admitted to intensive care directly from an emergency...

  • Laparoscopic versus open appendectomy. Kanat, Burhan Hakan; Turkoglu, Ahmet; Yur, Mesut; Girgin, Mustafa; Aslanmirza, Mehmet Yasar // HealthMed;2013, Vol. 7 Issue 4, p1220 

    Background and Aims: Our aim in this study is retrospective evaluation of patients with a diagnosis of acute appendicitis that underwent laparoscopic or open appendectomy and determination of the significance of laparoscopic appendectomy. Methods: In this study, the patients' data with a...

  • Comparison of the Electrothermal Vessel-Sealing System Versus Endoclip in Laparoscopic Appendectomy. Aydogan, Fatih; Saribeyoglu, Kaya; Simsek, Osman; Salihoglu, Ziya; Carkman, Sinan; Salihoglu, Tamer; Karatas, Adem; Baca, Bilgi; Kucuk, Ozan; Yavuz, Nihat; Pekmezci, Salih // Journal of Laparoendoscopic & Advanced Surgical Techniques;Jun2009, Vol. 19 Issue 3, p375 

    Background: Various techniques have been used for the division of mesoappendix, such as endoloops, endoscopic linear cutting staplers, an electrothermal vessel-sealing system (LigaSure), the Harmonic Scalpel, clips, and bipolar coagulation. In the present study, LigaSure and an endoclip were...

  • Is it necessary to perform appendicectomy in the middle of the night in children? Surana, Rajendra; Quinn, Feargal; Puri, Prem // BMJ: British Medical Journal (International Edition);5/1/93, Vol. 306 Issue 6886, p1168 

    Compares the outcome of children with appendicitis who underwent early appendectomy with those whose operation was delayed overnight. Recognition of appendectomy as a treatment of choice for acute appendicitis; Association between delay in appendectomy and increased risk of complications;...

  • Is Laparoscopic Appendectomy a Safe Procedure? I., Maiershon-Simion; T., Ezri; K., Dayan; M., Muggia-Sullam // Acta Medica Marisiensis;Apr2011, Vol. 57 Issue 2, p69 

    Background: Laparoscopic appendectomy (LA) is a common procedure, considered to be a safe alternative to conventional open appendectomy (OA). LA is known to reduce parietal scarring, offers a shortened hospital stay and an earlier return to normal activities. Acute gangrenous and perforated...

  • Thirty-day outcomes of laparoscopic versus open appendectomy in elderly using ACS/NSQIP database. Moazzez, Ashkan; Mason, Rodney; Katkhouda, Namir // Surgical Endoscopy;Apr2013, Vol. 27 Issue 4, p1061 

    Background: Although laparoscopic appendectomy is becoming the procedure of choice over open appendectomy in the treatment of appendicitis, its role in the elderly has not been widely studied. The objective of this study was to compare the 30-day outcomes after laparoscopic versus open for...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics