Laparoscopic or open appendectomy?
- 1 March 1998
- journal article
- review article
- Published by Wolters Kluwer Health in Diseases of the Colon & Rectum
- Vol. 41 (3), 398-403
- https://doi.org/10.1007/bf02237500
Abstract
A randomized, controlled trial is considered to be the “gold standard” to evaluate a new procedure. Thus, this critical review assessed whether the published randomized trials on laparoscopic appendectomy show that it is superior to the open approach. Twelve original articles involving a randomized, controlled trial on laparoscopic appendectomy in adults published between January 1990 and December 1996 were selected. We studied first whether each trial was positive (a procedure is superior to the other) or negative (no difference). We reviewed for each trial the methodology used and the following outcomes: operating time, intraoperative and postoperative complications, time until resumption of diet, postoperative pain, hospital stay, cost, and quality of life analyses. Post-operative morbidity was considered as the major primary outcome. There were six positive and six negative trials. Postoperative complication rates were similar, but the two approaches had specific potential complications, wound infections following open appendectomy, and intra-abdominal abscesses following laparoscopic appendectomy. This review failed to show a superiority of the laparoscopy for the other outcomes, particularly postoperative pain. Differences in positive trials concerned subjective and controversial outcomes, and the flaw in negative trials was their lack of power. Thus, nothing is definitively well established, even after 12 randomized trials.Keywords
This publication has 15 references indexed in Scilit:
- Analysis of randomized controlled trials in laparoscopic surgeryBritish Journal of Surgery, 1997
- Laparoscopy not recommended for routine appendectomy in men: Results of a prospective randomized studySurgery, 1996
- Laparoscopic Versus Open AppendectomySouthern Medical Journal, 1996
- Prospective Randomized Comparison of Open versus Laparoscopic Appendectomy in MenWorld Journal of Surgery, 1996
- Open Versus Laparoscopic Appendectomy A Prospective Randomized ComparisonAnnals of Surgery, 1995
- A prospective, randomized comparison of laparoscopic appendectomy with open appendectomyThe American Journal of Surgery, 1995
- A Prospective Randomized Trial Comparing Open Versus Laparoscopic AppendectomyAnnals of Surgery, 1994
- Randomized controlled trial comparing laparoscopic and open appendicectomyBritish Journal of Surgery, 1993
- Laparoscopic versus open appendicectomy: prospective randomised trialThe Lancet, 1993
- Incorporating variations in the quality of individual randomized trials into meta-analysisJournal of Clinical Epidemiology, 1992