Laparoscopic versus open appendectomy: Analysis of systemic acute-phase responses in a prospective randomized study
Background: The aim of this randomized study was to assess the postoperative acute-phase response of laparoscopic appendectomy and to compare its results with those of open appendectomy. Methods: 81 patients admitted to our emergency service with acute appendicitis were randomized to laparoscopic and open appendectomy groups. Preoperative and postoperative values for acute-phase reactants of white blood-cell count, erythrocyte sedimentation rate, C-reactive protein, and fibrinogen in blood samples were recorded. We also collected data concerning age and gender, total anesthesia time, operation time, time of oral intake, and hospital stay time of the study groups. Results: Although total anesthesia time was significantly longer in the laparoscopic group than in the open group ( p < 0.05), there was no significant difference in operation time between both groups ( p > 0.05). We found oral intake and hospital stay time to be significantly lower in the laparoscopic appendectomy group than in the open appendectomy group ( p < 0.05). The acute-phase reactant levels were significantly lower in the laparoscopic appendectomy group than in the open appendectomy group ( p < 0.05). Conclusion: Laparoscopic appendectomy causes relatively less trauma and less tissue damage than the open procedure and appears to have distinct advantages over open appendectomy.