MONDAY, Dec. 22, 2003 (HealthDayNews) -- If you have to have your appendix removed, laparoscopic surgery appears to offer clear advantages over traditional surgery for most patients.
That's the conclusion of a new study appearing in the January issue of the Annals of Surgery.
The study found people who had laparoscopic (also known as keyhole) surgery -- performed through small incisions with the use of cameras and special cauterizing, cutting and stapling instruments -- tended to have shorter hospital stays, a lower risk of infection and fewer complications than people who had standard surgery.
"This study really puts laparoscopic surgery in a very favorable light," says study author Dr. Ulrich Geller, who is currently a surgical resident at the University of Basel in Switzerland but was a surgical research fellow at Duke University at the time of the study.
"People should know that laparoscopic appendectomy exists and that they might have a quicker hospital stay with this procedure compared to the open procedure," he says. "We also found that laparoscopic surgery seemed to have advantages even if an abscess or perforation was present."
Dr. Bruce McIntosh, a surgeon at William Beaumont Hospital in Troy, Mich., says this finding was particularly interesting because surgeons often won't consider a laparoscopic approach on someone with a perforation or abscess.
The appendix is a small pouch attached to the right side of the colon that doesn't appear to be necessary for digestion. However, this tiny organ can become infected and can even burst, causing bacteria to spread into the abdomen. This can lead to a life-threatening infection.
Appendicitis most commonly occurs in people between the ages of 10 and 30, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for appendicitis is surgery -- appendectomy -- which can be performed laparoscopically or through a larger incision.
For this study, Guller and his colleagues looked at data from more than 43,000 people who had appendectomies. The data came from the 1997 National Inpatient Sample, a database containing discharge information on about 20 percent of all patients hospitalized in the United States in 1997.
Just over 17 percent of the people who had their appendix removed had laparoscopic surgery, according to the study.
The average hospital stay for those undergoing laparoscopic surgery was 2.06 days, compared to 2.88 for people who had open surgery. Those undergoing laparoscopic surgery had about half the risk of infection of open surgery patients, and about a 20 percent reduced risk of complications.
People who had the laparoscopic procedure were also more than three times as likely to be discharged home, rather than to a nursing home or home health care, according to the study.
Guller says because this is a retrospective study, the results must be interpreted with caution, and McIntosh agrees. McIntosh says it would also be helpful to see a cost analysis for both procedures, because while laparoscopic surgery may be a more expensive procedure initially, overall costs may even out if the hospital stay is shorter.
McIntosh says this was a well-constructed study that "sheds new light" on the idea of using laparoscopic surgery more often. He says given the size of the study, he may be rethinking his approach of using laparoscopic surgery for only about 15 percent to 17 percent of his patients.
But, he says, people should keep in mind that any surgery needs to be evaluated on an individual basis.
More information
To learn more about appendicitis, visit KidsHealth.org or the National Digestive Diseases Information Clearinghouse.
