Laparoscopic Versus Open Appendectomy in Adults and Children: A Meta-analysis of Randomized Controlled Trials

Overview

Journal United European Gastroenterol J

Publisher Wiley

Specialty Gastroenterology

Date 2017 Jun 8

PMID 28588886

Citations 24

Authors

Liping Dai

Jian Shuai

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to evaluate the differences of laparoscopic appendectomy (LA) versus open appendectomy (OA) in adults and children.

Methods: Randomized controlled trials (RCTs) comparing LA and OA in adults and children between January 1992-March 2016 were included in this study. A meta-analysis was performed to evaluate wound infection, intra-abdominal abscess, postoperative complications, reoperation rate, operation time, postoperative stay, and return to normal activity.

Result: Thirty-three studies including 3642 patients (1810 LA, 1832 OA) were included. Compared with OA, LA in adults was associated with lower incidence of wound infection, fewer postoperative complications, shorter postoperative stay, and earlier return to normal activity, but a longer operation time. There was no difference in levels of intra-abdominal abscess and reoperation between the groups. Subgroup analysis in children did not reveal significant differences between the two techniques in wound infection, postoperative complications, postoperative stay, and return to normal activity.

Conclusion: LA in adults is worth recommending as an effective and safe procedure for acute appendicitis, and further high-quality randomized trials comparing the two techniques in children are needed.

Citing Articles

Is Routine Group and Save Sampling Necessary for Emergency Laparoscopic Appendicectomy?.

Harrow S, Nadarajasundaram A Cureus. 2025; 17(1):e78086.

PMID: 39882197 PMC: 11774625. DOI: 10.7759/cureus.78086.

Acute appendicitis and its treatment: a historical overview.

Selvaggi L, Pata F, Pellino G, Podda M, Di Saverio S, De Luca G Int J Colorectal Dis. 2025; 40(1):28.

PMID: 39881071 PMC: 11779765. DOI: 10.1007/s00384-024-04793-7.

Single versus double Hem-o-lok clips to secure the apendiceal stump during laparoscopic appendectomy: a prospective randomized multicentric clinical trial.

Aday U, Cetin E, Kafadar M, Oguz A, Bahadir M, Ulger B Langenbecks Arch Surg. 2024; 409(1):89.

PMID: 38457041 PMC: 10924000. DOI: 10.1007/s00423-024-03281-4.

Laparoscopic versus open appendicectomy performed by adult general surgeons in pre-teenage years children: a single-centre experience.

Hannan E, Lim E, Feeney G, OBrien L, Coffey J, Peirce C Ann R Coll Surg Engl. 2024; 107(1):68-72.

PMID: 38362753 PMC: 11658871. DOI: 10.1308/rcsann.2023.0044.

Are Antibiotics the New Appendectomy?.

Alajaimi J, Almansoor M, Almutawa A, Almusalam M, Bakry H Cureus. 2023; 15(9):e44506.

PMID: 37790034 PMC: 10544542. DOI: 10.7759/cureus.44506.

References

Al-Mulhim A . Laparoscopic versus open appendectomy in females with a clinical diagnosis of appendicitis. Saudi Med J. 2002; 23(11):1339-42. View

van Dalen R, Bagshaw P, Dobbs B, Robertson G, Lynch A, Frizelle F . The utility of laparoscopy in the diagnosis of acute appendicitis in women of reproductive age. Surg Endosc. 2003; 17(8):1311-3. DOI: 10.1007/s00464-002-8710-4. View

Khalil J, Muqim R, Rafique M, Khan M . Laparoscopic versus open appendectomy: a comparison of primary outcome measures. Saudi J Gastroenterol. 2011; 17(4):236-40. PMC: 3133979. DOI: 10.4103/1319-3767.82574. View

Lintula H, Kokki H, Vanamo K, Antila P, Eskelinen M . Laparoscopy in children with complicated appendicitis. J Pediatr Surg. 2002; 37(9):1317-20. DOI: 10.1053/jpsu.2002.34998. View

Hellberg A, Rudberg C, Kullman E, Enochsson L, Fenyo G, Graffner H . Prospective randomized multicentre study of laparoscopic versus open appendicectomy. Br J Surg. 1999; 86(1):48-53. DOI: 10.1046/j.1365-2168.1999.00971.x. View

Little D, Custer M, May B, Blalock S, Cooney D . Laparoscopic appendectomy: An unnecessary and expensive procedure in children?. J Pediatr Surg. 2002; 37(3):310-7. DOI: 10.1053/jpsu.2002.30841. View

Wei B, Qi C, Chen T, Zheng Z, Huang J, Hu B . Laparoscopic versus open appendectomy for acute appendicitis: a metaanalysis. Surg Endosc. 2010; 25(4):1199-208. DOI: 10.1007/s00464-010-1344-z. View

Macarulla E, Vallet J, Abad J, Hussein H, Fernandez E, Nieto B . Laparoscopic versus open appendectomy: a prospective randomized trial. Surg Laparosc Endosc. 1997; 7(4):335-9. View

Laine S, Rantala A, Gullichsen R, Ovaska J . Laparoscopic appendectomy-is it worthwhile? A prospective, randomized study in young women. Surg Endosc. 1997; 11(2):95-7. DOI: 10.1007/s004649900305. View

10.

Paterson-Brown S, Thompson J, Eckersley J, Ponting G, Dudley H . Which patients with suspected appendicitis should undergo laparoscopy?. Br Med J (Clin Res Ed). 1988; 296(6633):1363-4. PMC: 2545831. DOI: 10.1136/bmj.296.6633.1363-a. View

11.

Hay S . Laparoscopic versus conventional appendectomy in children. Pediatr Surg Int. 1998; 13(1):21-3. DOI: 10.1007/s003830050235. View

12.

Kocatas A, Gonenc M, Bozkurt M, Karabulut M, Gemici E, Alis H . Comparison of open and laparoscopic appendectomy in uncomplicated appendicitis: a prospective randomized clinical trial. Ulus Travma Acil Cerrahi Derg. 2013; 19(3):200-4. DOI: 10.5505/tjtes.2013.58234. View

13.

Ortega A, Hunter J, Peters J, Swanstrom L, Schirmer B . A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic Appendectomy Study Group. Am J Surg. 1995; 169(2):208-12; discussion 212-3. DOI: 10.1016/s0002-9610(99)80138-x. View

14.

Kum C, Sim E, Goh P, Ngoi S, Rauff A . Diagnostic laparoscopy: reducing the number of normal appendectomies. Dis Colon Rectum. 1993; 36(8):763-6. DOI: 10.1007/BF02048368. View

15.

Kargar S, Mirshamsi M, Zare M, Arefanian S, Shadman Yazdi E, Aref A . Laparoscopic versus open appendectomy; which method to choose? A prospective randomized comparison. Acta Med Iran. 2011; 49(6):352-6. View

16.

Kaplan M, Salman B, Yilmaz T, Oguz M . A quality of life comparison of laparoscopic and open approaches in acute appendicitis: a randomised prospective study. Acta Chir Belg. 2009; 109(3):356-63. DOI: 10.1080/00015458.2009.11680439. View

17.

Reiertsen O, Larsen S, Trondsen E, Edwin B, Faerden A, Rosseland A . Randomized controlled trial with sequential design of laparoscopic versus conventional appendicectomy. Br J Surg. 1997; 84(6):842-7. View

18.

Ignacio R, Burke R, Spencer D, Bissell C, Dorsainvil C, Lucha P . Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc. 2003; 18(2):334-7. DOI: 10.1007/s00464-003-8927-x. View

19.

Lintula H, Kokki H, Vanamo K . Single-blind randomized clinical trial of laparoscopic versus open appendicectomy in children. Br J Surg. 2001; 88(4):510-4. DOI: 10.1046/j.1365-2168.2001.01723.x. View

20.

Lavonius M, Liesjarvi S, Ovaska J, Pajulo O, Ristkari S, Alanen M . Laparoscopic versus open appendectomy in children: a prospective randomised study. Eur J Pediatr Surg. 2001; 11(4):235-8. DOI: 10.1055/s-2001-17150. View