Laparoskopinės ir atviros apendektomijos metodų palyginimas ; Laparoscopic versus open appendectomy

Aim: To compare open and laparoscopic appendectomy. Objectives: 1. To compare surgery duration; 2. hospitalization time; 3. complications and rate of them; 4. surgery price; 5. consumed narcotic analgesics; 6. to evaluate which younger or older surgeons choose open appendectomy. Methods: It was a retrospective study. Statistical analysis was performed using SPSS 20.0 software. Study participants: The study consisted of 373 patients diagnosed with acute appendicitis and operated from 2015 to 2016 in Kaunas Clinical Hospital General Surgery Clinic. Results: Laparoscopic appendectomy operation was performed on 302 (80.97%) patients and open appendectomy operation on 71 (19.03%). Laparoscopic appendectomy surgery median duration was 90 minutes (36-240, average 99.1) and open appendectomy operation median duration - 90 min. (60-255, average 99.9). Duration of hospitalization after laparoscopic appendectomy median time was 3 days (1-23, average 3.39) and open appendectomy median hospitalization time was 4 days (2-17, average 4.84). Laparoscopic surgery transition to an open appendectomy was recorded 7 times (2.3%) among laparoscopic appendectomy patients. Among open appendectomy patients, 2 (2.8%) had surgical wound infection and 1 (1.4 %) patient had ileus. Payment for laparoscopic and open surgery is the same, 1 hospitalization day is valued at 497.68 euro, two hospitalization days - 690.41 euro. Subsequent hospitalization days are unpaid. The majority of patients (88.7%) after open appendectomy were hospitalized for 3 or more days. After laparoscopic surgery there were patients hospitalized for only one day (3.6%), more patients hospitalized for 2 days (36.1%) compared to open surgery and less patients were hospitalized for 3 or more days (60.3%). Laparoscopic appendectomy had an average consumption of 3.39 ampoules phentanyl and open appendectomy required an average of 4.84 phentanyl ampoules. Using Poisson regression showed that there is no statistically significant relationship between type of operation and ...