Systematic Review of Laparoscopic Versus Open Appendectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HE Huan , ZHANG Shu , LI Yuntao , LIU Yanjun , HOU Kang , XIA Xiang

Department of General Surgery， The Third People’s Hospital of Chengdu City，Chengdu 610031， Sichuan Province， China;

Corresponding author：

Keywords：

Laparoscopic appendectomy; Open appendectomy; Appendicitis; Systematic review; Meta analysis

Video：

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Objective 　To evaluate the clinical effectiveness of laparoscopic and open appendectomy.
Methods 　Literatures relating to randomized controlled trials in English and Chinese on the comparison of clinical effectiveness after laparoscopic and open appendectomy in appendicitis from PubMed，Wiley Online Library，Medline，Embase，Cochrane，CNKI，VIP，CBM databases were extracted，and methodological quality was evaluated by two reviewers independently with designed extraction form. The Cochrane Collaboration’s RevMan 4.2.2 software was used for data analysis. The wound infection，hospitalization time，operation time，hospitalization expenses，and peritoneal abscess were compared between laparoscopic and open appendectomy.
Results 　Eight published reports of eligible studies were extracted. Compared with the open appendectomy， laparoscopic appendectomy had significant differences in lower wound infection rate 〔OR=0.19，95%CI （0.09，0.38），P＜0.000 01〕， longer operation time 〔WMD=3.66，95%CI （0.50，6.82），P=0.02〕，and more hospitalization expenses〔WMD=503.96，95%CI （337.23，670.70），P＜0.000 01〕.But there were no significant differences in hospitalization time〔WMD=-0.11，95%CI （-3.64，3.43），P=0.95〕 and incidence rate of peritoneal abscess 〔OR=1.40，95%CI （0.23，8.64），P=0.71〕 between laparoscopic and open appendectomy.
Conclusions 　The wound infection rate is lower，but the operation time is longer，the hospitalization expenses is more in laparoscopic appendectomy as compared with open appendectomy. There are no statistically significant differences of hospitalization time and incidence rate of abdominal abscess between laparoscopic and open appendectomy.

Citation： HE Huan,ZHANG Shu,LI Yuntao,LIU Yanjun,HOU Kang,XIA Xiang,.. Systematic Review of Laparoscopic Versus Open Appendectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(5): 538-543. doi: Copy

1.	Chalmers TC， Smith H Jr， Blackburn B， et al. A method for assessing the quality of a randomized control trial [J]. Control Clin Trials， 1981， 2(1)：31-49.
2.	Schulz KF， Chalmers I， Hayes RJ， et al. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials [J]. JAMA， 1995，273(5)：408-412.
3.	Moher D，Pham B， Jones A， et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? [J]. Lancet， 1998， 352(9128)：609-613.
4.	Kjaergard LL， Villumsen J， Gluud C. Reported methodologic quality and discrepancies between large and small randomized tri-als in meta-analyses [J]. Ann Intern Med， 2001， 135(11)：982-989.
5.	Stroup DF， Berlin JA， Morton SC， et al. Meta-analysis of observational studies in epidemiology：a proposal for reporting. Metaanalysis Of Observational Studies in Epidemiology (MOOSE)group [J]. JAMA， 2000，283(15)：2008-2012.
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7.	Clarkr M， Oxman AD， et al. Cohrane Reviewers Handbook 4.2[ updated April 2004]. In：Review Manager[ Computer program ]. Version 4.2. Oxford， England：The Cohrane Collaboration，2004.
8.	Shirazi B， Ali N， Shamim MS. Laproscopic versus open appendectomy：a comparative study [J]. J Pak Med Assoc， 2010，60(11)：901-904.
9.	Koluh A， Delibegovic S， Hasukic S，et al. Laparoscopic appendectomy in the treatment of acute appendicitis [J]. Med Arh，2010， 64(3)：147-150.
10.	Kaplan M， Salman B， Yilmaz TU， et al. A quality of life comparison of laparoscopic and open approaches in acute appendicitis：a randomised prospective study [J]. Acta Chir Belg，2009，109(3)：356-363.
11.	Wei HB， Huang JL， Zheng ZH， et al. Laparoscopic versus open appendectomy：a prospective randomized comparison [J]. Surg Endosc，2010， 24(2)：266-269.
12.	Hart R， Rajgopal C， Plewes A， et al. Laparoscopic versus open appendectomy：a prospective randomized trial of 81 patients [J].Can J Surg， 1996， 39(6)：457-462.
13.	Klingler A， Henle KP， Beller S， et al. Laparoscopic appendectomy does not change the incidence of postoperative infectious complications [J]. Am J Surg， 1998， 175(3)：232-235.
14.	Pedersen AG， Petersen OB， Wara P， et al. Randomized clinical trial of laparoscopic versus open appendicectomy [J]. Br J Surg，2001， 88(2)：200-205.
15.	Hansen JB， Smithers BM， Schache D， et al. Laparoscopic versus open appendectomy：prospective randomized trial [J].World J Surg， 1996， 20(1)：17-20.
16.	Kehagias I， Karamanakos SN， Panagiotopoulos S， et al. Laparoscopic versus open appendectomy：Which way to go? [J]. World J Gastroenterol， 2008， 14(31)：4909-4914.
17.	Grewal H， Sweat J， Vazquez WD. Laparoscopic appendectomy in children can be done as a fast-track or same-day surgery [J].JSLS， 2004， 8：151-154.
18.	Markar SR， Venkat-Raman V， Ho A， et al. Laparoscopic versus open appendicectomy in obese patients [J]. Int J Surg， 2011，9(6)：451- 455.
19.	Masoomi H， Nguyen NT， Dolich MO， et al. Comparison of laparoscopic versus open appendectomy for acute nonperforated and perforated appendicitis in the obese population [J]. Am J Surg， 2011， 202(6)：733-738.
20.	Yeh CC， Wu SC， Liao CC， et al. Laparoscopic appendectomy for acute appendicitis is more favorable for patients with comorbidities，the elderly， and those with complicated appendicitis：a nationwide population-based study [J]. Surg Endosc， 2011，25(9)：2932-2942.
21.	Wu SC， Wang YC， Fu CY， et al. Laparoscopic appendectomy provides better outcomes than open appendectomy in elderly patients [J]. Am Surg， 2011， 77(4)：466-470.
22.	Liang HH， Wang W， Huang MT， et al. Appendix diameter：a predictor of wound infection after laparoscopic appendectomy[J]. Am Surg， 2011， 77(3)：307-310.
23.	Lim SG， Ahn EJ， Kim SY， et al. A clinical comparison of laparoscopic versus open appendectomy for complicated appendicitis [J]. J Korean Soc Coloproctol， 2011， 27(6)：293-297.
24.	Moore CB， Smith RS， Herbertson R， et al. Does use of intraoperative irrigation with open or laparoscopic appendectomy reduce post-operative intra-abdominal abscess? [J]. Am Surg， 2011，77(1)：78-80.
25.	Gupta R， Sample C， Bamehriz F， et al. Infectious complications following laparoscopic appendectomy [J]. Can J Surg， 2006，49：397-400.
26.	Memon MA. Laparoscopic appendectomy：current status [J].Ann R Coll Surg Eng， 1997， 79：393-402.

1. Chalmers TC， Smith H Jr， Blackburn B， et al. A method for assessing the quality of a randomized control trial [J]. Control Clin Trials， 1981， 2(1)：31-49.
2. Schulz KF， Chalmers I， Hayes RJ， et al. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials [J]. JAMA， 1995，273(5)：408-412.
3. Moher D，Pham B， Jones A， et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? [J]. Lancet， 1998， 352(9128)：609-613.
4. Kjaergard LL， Villumsen J， Gluud C. Reported methodologic quality and discrepancies between large and small randomized tri-als in meta-analyses [J]. Ann Intern Med， 2001， 135(11)：982-989.
5. Stroup DF， Berlin JA， Morton SC， et al. Meta-analysis of observational studies in epidemiology：a proposal for reporting. Metaanalysis Of Observational Studies in Epidemiology (MOOSE)group [J]. JAMA， 2000，283(15)：2008-2012.
6. Alderson P， Green S， Higgins JPT， et al. Cohrane Reviewers Handbook 4.2.2 [updated December 2003][M]. In：The Cohrane Library. Chichester， UK：John Wiley and Sons，Ltd，2004， Issue 1.
7. Clarkr M， Oxman AD， et al. Cohrane Reviewers Handbook 4.2[ updated April 2004]. In：Review Manager[ Computer program ]. Version 4.2. Oxford， England：The Cohrane Collaboration，2004.
8. Shirazi B， Ali N， Shamim MS. Laproscopic versus open appendectomy：a comparative study [J]. J Pak Med Assoc， 2010，60(11)：901-904.
9. Koluh A， Delibegovic S， Hasukic S，et al. Laparoscopic appendectomy in the treatment of acute appendicitis [J]. Med Arh，2010， 64(3)：147-150.
10. Kaplan M， Salman B， Yilmaz TU， et al. A quality of life comparison of laparoscopic and open approaches in acute appendicitis：a randomised prospective study [J]. Acta Chir Belg，2009，109(3)：356-363.
11. Wei HB， Huang JL， Zheng ZH， et al. Laparoscopic versus open appendectomy：a prospective randomized comparison [J]. Surg Endosc，2010， 24(2)：266-269.
12. Hart R， Rajgopal C， Plewes A， et al. Laparoscopic versus open appendectomy：a prospective randomized trial of 81 patients [J].Can J Surg， 1996， 39(6)：457-462.
13. Klingler A， Henle KP， Beller S， et al. Laparoscopic appendectomy does not change the incidence of postoperative infectious complications [J]. Am J Surg， 1998， 175(3)：232-235.
14. Pedersen AG， Petersen OB， Wara P， et al. Randomized clinical trial of laparoscopic versus open appendicectomy [J]. Br J Surg，2001， 88(2)：200-205.
15. Hansen JB， Smithers BM， Schache D， et al. Laparoscopic versus open appendectomy：prospective randomized trial [J].World J Surg， 1996， 20(1)：17-20.
16. Kehagias I， Karamanakos SN， Panagiotopoulos S， et al. Laparoscopic versus open appendectomy：Which way to go? [J]. World J Gastroenterol， 2008， 14(31)：4909-4914.
17. Grewal H， Sweat J， Vazquez WD. Laparoscopic appendectomy in children can be done as a fast-track or same-day surgery [J].JSLS， 2004， 8：151-154.
18. Markar SR， Venkat-Raman V， Ho A， et al. Laparoscopic versus open appendicectomy in obese patients [J]. Int J Surg， 2011，9(6)：451- 455.
19. Masoomi H， Nguyen NT， Dolich MO， et al. Comparison of laparoscopic versus open appendectomy for acute nonperforated and perforated appendicitis in the obese population [J]. Am J Surg， 2011， 202(6)：733-738.
20. Yeh CC， Wu SC， Liao CC， et al. Laparoscopic appendectomy for acute appendicitis is more favorable for patients with comorbidities，the elderly， and those with complicated appendicitis：a nationwide population-based study [J]. Surg Endosc， 2011，25(9)：2932-2942.
21. Wu SC， Wang YC， Fu CY， et al. Laparoscopic appendectomy provides better outcomes than open appendectomy in elderly patients [J]. Am Surg， 2011， 77(4)：466-470.
22. Liang HH， Wang W， Huang MT， et al. Appendix diameter：a predictor of wound infection after laparoscopic appendectomy[J]. Am Surg， 2011， 77(3)：307-310.
23. Lim SG， Ahn EJ， Kim SY， et al. A clinical comparison of laparoscopic versus open appendectomy for complicated appendicitis [J]. J Korean Soc Coloproctol， 2011， 27(6)：293-297.
24. Moore CB， Smith RS， Herbertson R， et al. Does use of intraoperative irrigation with open or laparoscopic appendectomy reduce post-operative intra-abdominal abscess? [J]. Am Surg， 2011，77(1)：78-80.
25. Gupta R， Sample C， Bamehriz F， et al. Infectious complications following laparoscopic appendectomy [J]. Can J Surg， 2006，49：397-400.
26. Memon MA. Laparoscopic appendectomy：current status [J].Ann R Coll Surg Eng， 1997， 79：393-402.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Systematic Review of Laparoscopic Versus Open Appendectomy

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