Surgery
Volume 148, Issue 4 , Pages 625-637 , October 2010

Comparison of outcomes after laparoscopic versus open appendectomy for acute appendicitis at 222 ACS NSQIP hospitals

Presented at the Central Surgical Association 2010 Annual Meeting, March 10–13, 2010, Chicago, Illinois.

  • Angela M. Ingraham, MD

      Affiliations

    • Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL
    • Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
    • Corresponding Author InformationReprint requests: Angela M. Ingraham, MD, American College of Surgeons, 633 N St. Clair Street, Floor 22NE, Chicago, IL 60611.
  • ,
  • Mark E. Cohen, PhD

      Affiliations

    • Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL
  • ,
  • Karl Y. Bilimoria, MD, MS

      Affiliations

    • Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL
  • ,
  • Timothy A. Pritts, MD, PhD

      Affiliations

    • Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
  • ,
  • Clifford Y. Ko, MD, MS, MSHS

      Affiliations

    • Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL
    • Department of Surgery, University of California, Los Angeles (UCLA) and VA Greater Los Angeles Healthcare System, Los Angeles, CA
  • ,
  • Thomas J. Esposito, MD, MPH

      Affiliations

    • Department of Surgery, Loyola University Chicago Stritch School of Medicine, Maywood, IL

,Accepted 15 July 2010.

References 

  1. Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990;132:910–925
  2. U.S. Department of Health and Human Services, National Center for Health Statistics. National Health Statistics Reports. 2006 National Hospital Discharge Survey. National Center for Health Statistics, Hyattsville, MD; 2008.
  3. U.S. Department of Health and Human Services, National Center for Health Statistics. National Health Statistics Reports. Ambulatory surgery in the United States, 2006. National Center for Health Statistics, Hyattsville, MD; 2009.
  4. Semm K. Endoscopic appendectomy. Endoscopy. 1983;15:59–64
  5. Long KH, Bannon MP, Zietlow SP, et al. A prospective randomized comparison of laparoscopic appendectomy with open appendectomy: clinical and economic analyses. Surgery. 2001;129:390–400
  6. Peiser JG, Greenberg D. Laparoscopic versus open appendectomy: results of a retrospective comparison in an Israeli hospital. Isr Med Assoc J. 2002;4:91–94
  7. Maxwell JG, Robinson CL, Maxwell TG, et al. Deriving the indications for laparoscopic appendectomy from a comparison of the outcomes of laparoscopic and open appendectomy. Am J Surg. 2001;182:687–692
  8. Fingerhut A, Millat B, Borrie F. Laparoscopic versus open appendectomy: time to decide. World J Surg. 1999;23:835–845
  9. Guller U, Hervey S, Purves H, et al. Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative database. Ann Surg. 2004;239:43–52
  10. Khuri SF, Daley J, Henderson W, et al. The National Veterans Administration Surgical Risk Study: risk adjustment for the comparative assessment of the quality of surgical care. J Am Coll Surg. 1995;180:519–531
  11. Khuri SF, Daley J, Henderson W, et al. The Department of Veterans Affairs' NSQIP: the first national, validated, outcome-based, risk-adjusted, and peer-controlled program for the measurement and enhancement of the quality of surgical care. National VA Surgical Quality Improvement Program. Ann Surg. 1998;228:491–507
  12. Khuri SF. The NSQIP: a new frontier in surgery. Surgery. 2005;138:837–843
  13. Khuri SF, Henderson WG, Daley J, et al. The patient safety in surgery study: background, study design, and patient populations. J Am Coll Surg. 2007;204:1089–1102
  14. American College of Surgeons. American College of Surgeons National Surgical Quality Improvement Program operations manual. American College of Surgeons, Chicago, IL; 2007.
  15. Luellen JK, Shadish WR, Clark MH. Propensity scores: an introduction and experimental test. Eval Rev. 2005;29:530–558
  16. American Hospital Association . AHA Annual Survey Database™ for fiscal year 2008. Vol. 2009;American Hospital Association, Chicago, IL
  17. Attwood SE, Hill AD, Murphy PG, et al. A prospective randomized trial of laparoscopic versus open appendectomy. Surgery. 1992;112:497–501
  18. Cox MR, McCall JL, Toouli J, et al. Prospective randomized comparison of open versus laparoscopic appendectomy in men. World J Surg. 1996;20:263–266
  19. Frazee RC, Roberts JW, Symmonds RE, et al. A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg. 1994;219:725–728
  20. Hansen JB, Smithers BM, Schache D, et al. Laparoscopic versus open appendectomy: prospective randomized trial. World J Surg. 1996;20:17–20
  21. Ignacio RC, Burke R, Spencer D, et al. Laparoscopic versus open appendectomy: what is the real difference? Results of a prospective randomized double-blinded trial. Surg Endosc. 2004;18:334–337
  22. Kazemier G, de Zeeuw GR, Lange JF, et al. Laparoscopic vs open appendectomy. A randomized clinical trial. Surg Endosc. 1997;11:336–340
  23. Klingler A, Henle KP, Beller S, et al. Laparoscopic appendectomy does not change the incidence of postoperative infectious complications. Am J Surg. 1998;175:232–235
  24. Kum CK, Ngoi SS, Goh PM, et al. Randomized controlled trial comparing laparoscopic and open appendicectomy. Br J Surg. 1993;80:1599–1600
  25. Laine S, Rantala A, Gullichsen R, Ovaska J. Laparoscopic appendectomy-is it worthwhile? A prospective, randomized study in young women. Surg Endosc. 1997;11:95–97
  26. Macarulla E, Vallet J, Abad JM, et al. Laparoscopic versus open appendectomy: a prospective randomized trial. Surg Laparosc Endosc. 1997;7:335–339
  27. Martin LC, Puente I, Sosa JL, et al. Open versus laparoscopic appendectomy. A prospective randomized comparison. Ann Surg. 1995;222:256–261
  28. Minne L, Varner D, Burnell A, et al. Laparoscopic vs open appendectomy. Prospective randomized study of outcomes. Arch Surg. 1997;132:708–711
  29. Mutter D, Vix M, Bui A, et al. Laparoscopy not recommended for routine appendectomy in men: results of a prospective randomized study. Surgery. 1996;120:71–74
  30. Ortega AE, Hunter JG, Peters JH, et al. A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Laparoscopic Appendectomy Study Group. Am J Surg. 1995;169:208–212
  31. Tate JJ, Dawson JW, Chung SC, et al. Laparoscopic versus open appendicectomy: prospective randomised trial. Lancet. 1993;342:633–637
  32. Heikkinen TJ, Haukipuro K, Hulkko A. Cost-effective appendectomy. Open or laparoscopic? A prospective randomized study. Surg Endosc. 1998;12:1204–1208
  33. Hellberg A, Rudberg C, Kullman E, et al. Prospective randomized multicentre study of laparoscopic versus open appendicectomy. Br J Surg. 1999;86:48–53
  34. Larsson PG, Henriksson G, Olsson M, et al. Laparoscopy reduces unnecessary appendicectomies and improves diagnosis in fertile women. A randomized study. Surg Endosc. 2001;15:200–202
  35. Milewczyk M, Michalik M, Ciesielski M. A prospective, randomized, unicenter study comparing laparoscopic and open treatments of acute appendicitis. Surg Endosc. 2003;17:1023–1028
  36. Pedersen AG, Petersen OB, Wara P, et al. Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg. 2001;88:200–205
  37. Reiertsen O, Larsen S, Trondsen E, et al. Randomized controlled trial with sequential design of laparoscopic versus conventional appendicectomy. Br J Surg. 1997;84:842–847
  38. Chung RS, Rowland DY, Li P, Diaz J. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg. 1999;177:250–256
  39. Garbutt JM, Soper NJ, Shannon WD, et al. Meta-analysis of randomized controlled trials comparing laparoscopic and open appendectomy. Surg Laparosc Endosc. 1999;9:17–26
  40. Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a metaanalysis. J Am Coll Surg. 1998;186:545–553
  41. Sauerland S, Lefering R, Holthausen U, Neugebauer EA. Laparoscopic vs conventional appendectomy—a meta-analysis of randomised controlled trials. Langenbecks Arch Surg. 1998;383:289–295
  42. McCall JL, Sharples K, Jadallah F. Systematic review of randomized controlled trials comparing laparoscopic with open appendicectomy. Br J Surg. 1997;84:1045–1050
  43. Slim K, Pezet D, Chipponi J. Laparoscopic or open appendectomy? Critical review of randomized, controlled trials. Dis Colon Rectum. 1998;41:398–403
  44. Kapischke M, Caliebe A, Tepel J, et al. Open versus laparoscopic appendicectomy: a critical review. Surg Endosc. 2006;20:1060–1068
  45. Nazzal M, Ali MA, Turfah F, et al. Laparoscopic appendectomy: a viable alternative approach. J Laparoendosc Adv Surg Tech A. 1997;7:1–6
  46. Moberg AC, Montgomery A. Appendicitis: laparoscopic versus conventional operation: a study and review of the literature. Surg Laparosc Endosc. 1997;7:459–463
  47. Fallahzadeh H. Should a laparoscopic appendectomy be done?. Am Surg. 1998;64:231–233
  48. Lejus C, Delile L, Plattner V, et al. Randomized, single-blinded trial of laparoscopic versus open appendectomy in children: effects on postoperative analgesia. Anesthesiology. 1996;84:801–806
  49. Katkhouda N, Mason RJ, Towfigh S, et al. Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg. 2005;242:439–448
  50. Carbonell AM, Burns JM, Lincourt AE, Harold KL. Outcomes of laparoscopic versus open appendectomy. Am Surg. 2004;70:759–765
  51. Yong JL, Law WL, Lo CY, Lam CM. A comparative study of routine laparoscopic versus open appendectomy. JSLS. 2006;10:188–192
  52. Heinzelmann M, Simmen HP, Cummins AS, Largiader F. Is laparoscopic appendectomy the new 'gold standard'?. Arch Surg. 1995;130:782–785
  53. Richards KF, Fisher KS, Flores JH, Christensen BJ. Laparoscopic appendectomy: comparison with open appendectomy in 720 patients. Surg Laparosc Endosc. 1996;6:205–209
  54. Ozmen MM, Zulfikaroglu B, Tanik A, Kale IT. Laparoscopic versus open appendectomy: prospective randomized trial. Surg Laparosc Endosc Percutan Tech. 1999;9:187–189
  55. Merhoff AM, Merhoff GC, Franklin ME. Laparoscopic versus open appendectomy. Am J Surg. 2000;179:375–378
  56. Hoehne F, Ozaeta M, Sherman B, et al. Laparoscopic versus open appendectomy: is the postoperative infectious complication rate different?. Am Surg. 2005;71:813–815
  57. Hebebrand D, Troidl H, Spangenberger W, et al. [Laparoscopic or classical appendectomy? A prospective randomized study]. Chirurg. 1994;65:112–120
  58. Henle KP, Beller S, Rechner J, et al. [Laparoscopic versus conventional appendectomy: a prospective randomized study]. Chirurg. 1996;67:526–530
  59. Bisset AF. Appendicectomy in Scotland: a 20-year epidemiological comparison. J Public Health Med. 1997;19:213–218
  60. Blomqvist PG, Andersson RE, Granath F, et al. Mortality after appendectomy in Sweden, 1987–1996. Ann Surg. 2001;233:455–460
  61. Temple LK, Litwin DE, McLeod RS. A meta-analysis of laparoscopic versus open appendectomy in patients suspected of having acute appendicitis. Cn J Surg. 1999;42:377–383
  62. Vallina VL, Velasco JM, McCulloch CS. Laparoscopic versus conventional appendectomy. Ann Surg. 1993;218:685–692
  63. Agresta F, De Simone P, Michelet I, et al. [The rationale of laparoscopic treatment in acute appendiceal disease]. Chir Ital. 2000;52:171–178
  64. Johnson AB, Peetz ME. Laparoscopic appendectomy is an acceptable alternative for the treatment of perforated appendicitis. Surg Endosc. 1998;12:940–943
  65. Kurtz RJ, Heimann TM. Comparison of open and laparoscopic treatment of acute appendicitis. Am J Surg. 2001;182:211–214
  66. Towfigh S, Chen F, Mason R, et al. Laparoscopic appendectomy significantly reduces length of stay for perforated appendicitis. Surg Endosc. 2006;20:495–499
  67. Bresciani C, Perez RO, Habr-Gama A, et al. Laparoscopic versus standard appendectomy outcomes and cost comparisons in the private sector. J Gastrointest Surg. 2005;9:1174–1180
  68. Apelgren KN, Molnar RG, Kisala JM. Laparoscopic is not better than open appendectomy. Am Surg. 1995;61:240–243
  69. Cothren CC, Moore EE, Johnson JL, et al. Can we afford to do laparoscopic appendectomy in an academic hospital?. Am J Surg. 2005;190:950–954
  70. Ball CG, Kortbeek JB, Kirkpatrick AW, Mitchell P. Laparoscopic appendectomy for complicated appendicitis: an evaluation of postoperative factors. Surg Endosc. 2004;18:969–973
  71. Wullstein C, Barkhausen S, Gross E. Results of laparoscopic vs. conventional appendectomy in complicated appendicitis. Dis Colon Rectum. 2001;44:1700–1705
  72. Lin HF, Wu JM, Tseng LM, et al. Laparoscopic versus open appendectomy for perforated appendicitis. J Gastrointest Surg. 2006;10:906–910
  73. Yau KK, Siu WT, Tang CN, et al. Laparoscopic versus open appendectomy for complicated appendicitis. J Am Coll Surg. 2007;205:60–65
  74. Paik PS, Towson JA, Anthone GJ, et al. Intra-abdominal abscesses following laparoscopic and open appendectomies. J Gastrointest Surg. 1997;1:188–192
  75. Garg CP, Vaidya BB, Chengalath MM. Efficacy of laparoscopy in complicated appendicitis. Int J Surg. 2009;7:250–252
  76. Katsuno G, Nagakari K, Yoshikawa S, et al. Laparoscopic appendectomy for complicated appendicitis: a comparison with open appendectomy. World J Surg. 2009;33:208–214
  77. Pokala N, Sadhasivam S, Kiran RP, Parithivel V. Complicated appendicitis—is the laparoscopic approach appropriate? A comparative study with the open approach: outcome in a community hospital setting. Am Surg. 2007;73:737–741
  78. Nguyen NT, Zainabadi K, Mavandadi S, et al. Trends in utilization and outcomes of laparoscopic versus open appendectomy. Am J Surg. 2004;188:813–820

 Dr Ingraham is supported by the Clinical Scholar in Residence Program at the American College of Surgeons. Dr Bilimoria is supported by a Priority Grant from Northwestern University.

 Dr Ingraham had full access to all of the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis.

PII: S0039-6060(10)00393-4

doi: 10.1016/j.surg.2010.07.025

Surgery
Volume 148, Issue 4 , Pages 625-637 , October 2010