Needlescopic, laparoscopic, and open appendectomy: A comparative study

M. T. Huang, P. L. Wei, C. C. Wu, I. R. Lai, R. J. Chen, W. J. Lee

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

The benefits of laparoscopic appendectomy appear to be controversial. Since 1994, several abdominal procedures have been completed by using the needlescopic technique, but there appear to be no prospective studies to demonstrate the perceived benefits of needlescopic appendectomy. The authors compared open, laparoscopic, and needlescopic appendectomy in a randomized fashion with regard to duration of surgery, length of hospitalization, analgesic dosage, and surgery-associated complications. From March to July 1998, 75 patients admitted at the emergency station of the authors' hospital with a final diagnosis of acute appendicitis without tumor formation were randomized to receive one of the three treatment categories: open (OA), laparoscopic (LA), and needlescopic (nLA) appendectomy. Laparoscopic and needlescopic appendectomy were performed by using a three-port technique, although the size of the trocar used varied. There were 26 patients in the OA group, 23 in the LA group, and 26 in the nLA group. The mean operation durations for the OA, LA, and nLA groups were 55.4 ± 28.0 minutes, 69.1 ± 48.8 minutes, and 62.3 ± 26.3 minutes, respectively, and these were not significantly different from one another. The mean number of the analgesic doses (Pethidine 1 mg/kg) required was 1.3 ± 1.2 mg/kg, 0.5 ± 0.8 mg/kg, and 0.2 ± 0.6 mg/kg, respectively. Significant differences were noted when comparing the OA with the LA or nLA groups (OA vs. LA, P = 0.02; OA vs. nLA, P = 0.0002; LA vs. nLA, P = 0.06). The mean oral intake durations were 32.2 ± 16.9 hours, 21.0 ± 14.6 hours, and 20.8 ± 16.4 hours, respectively, after surgery for the OA, LA, and nLA groups, and the between-group differences were statistically significant for the OA versus LA group (P = 0.004) and for the OA versus nLA group (P = 0.003). The mean durations of hospitalization for the OA, LA, and nLA groups were 3.6 ± 1.8 days, 2.8 ± 1.4 days, and 2.4 ± 0.9 days, and difference was detected between the OA and the nLA groups (P = 0.02). The OA group rendered a greater wound-complication rate and ileus than did the other two groups, but the differences were not detected between the three categories (P = 0.065, 0.6935). The result of the current study confirmed that the nLA procedure is a feasible and safe one. The nLA procedure provided substantial advantages over the OA procedure in the contexts of diminished postoperative pain and shorter hospital stay without significant increases in postoperative complication rate or surgical time.

Original languageEnglish
Pages (from-to)306-312
Number of pages7
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume11
Issue number5
DOIs
Publication statusPublished - 2001
Externally publishedYes

Fingerprint

Appendectomy
Analgesics
Hospitalization
Meperidine
Ileus
Appendicitis
Operative Time
Postoperative Pain
Surgical Instruments
Laparoscopy
Length of Stay
Emergencies
Prospective Studies
Wounds and Injuries
Neoplasms

Keywords

  • Acute appendicitis
  • Laparoscopic appendectomy
  • Needlescopic appendectomy

ASJC Scopus subject areas

  • Surgery

Cite this

Needlescopic, laparoscopic, and open appendectomy : A comparative study. / Huang, M. T.; Wei, P. L.; Wu, C. C.; Lai, I. R.; Chen, R. J.; Lee, W. J.

In: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, Vol. 11, No. 5, 2001, p. 306-312.

Research output: Contribution to journalArticle

@article{a64d0b4191ac4824876677d2932a77fe,
title = "Needlescopic, laparoscopic, and open appendectomy: A comparative study",
abstract = "The benefits of laparoscopic appendectomy appear to be controversial. Since 1994, several abdominal procedures have been completed by using the needlescopic technique, but there appear to be no prospective studies to demonstrate the perceived benefits of needlescopic appendectomy. The authors compared open, laparoscopic, and needlescopic appendectomy in a randomized fashion with regard to duration of surgery, length of hospitalization, analgesic dosage, and surgery-associated complications. From March to July 1998, 75 patients admitted at the emergency station of the authors' hospital with a final diagnosis of acute appendicitis without tumor formation were randomized to receive one of the three treatment categories: open (OA), laparoscopic (LA), and needlescopic (nLA) appendectomy. Laparoscopic and needlescopic appendectomy were performed by using a three-port technique, although the size of the trocar used varied. There were 26 patients in the OA group, 23 in the LA group, and 26 in the nLA group. The mean operation durations for the OA, LA, and nLA groups were 55.4 ± 28.0 minutes, 69.1 ± 48.8 minutes, and 62.3 ± 26.3 minutes, respectively, and these were not significantly different from one another. The mean number of the analgesic doses (Pethidine 1 mg/kg) required was 1.3 ± 1.2 mg/kg, 0.5 ± 0.8 mg/kg, and 0.2 ± 0.6 mg/kg, respectively. Significant differences were noted when comparing the OA with the LA or nLA groups (OA vs. LA, P = 0.02; OA vs. nLA, P = 0.0002; LA vs. nLA, P = 0.06). The mean oral intake durations were 32.2 ± 16.9 hours, 21.0 ± 14.6 hours, and 20.8 ± 16.4 hours, respectively, after surgery for the OA, LA, and nLA groups, and the between-group differences were statistically significant for the OA versus LA group (P = 0.004) and for the OA versus nLA group (P = 0.003). The mean durations of hospitalization for the OA, LA, and nLA groups were 3.6 ± 1.8 days, 2.8 ± 1.4 days, and 2.4 ± 0.9 days, and difference was detected between the OA and the nLA groups (P = 0.02). The OA group rendered a greater wound-complication rate and ileus than did the other two groups, but the differences were not detected between the three categories (P = 0.065, 0.6935). The result of the current study confirmed that the nLA procedure is a feasible and safe one. The nLA procedure provided substantial advantages over the OA procedure in the contexts of diminished postoperative pain and shorter hospital stay without significant increases in postoperative complication rate or surgical time.",
keywords = "Acute appendicitis, Laparoscopic appendectomy, Needlescopic appendectomy",
author = "Huang, {M. T.} and Wei, {P. L.} and Wu, {C. C.} and Lai, {I. R.} and Chen, {R. J.} and Lee, {W. J.}",
year = "2001",
doi = "10.1097/00019509-200110000-00004",
language = "English",
volume = "11",
pages = "306--312",
journal = "Surgical Laparoscopy and Endoscopy",
issn = "1530-4515",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Needlescopic, laparoscopic, and open appendectomy

T2 - A comparative study

AU - Huang, M. T.

AU - Wei, P. L.

AU - Wu, C. C.

AU - Lai, I. R.

AU - Chen, R. J.

AU - Lee, W. J.

PY - 2001

Y1 - 2001

N2 - The benefits of laparoscopic appendectomy appear to be controversial. Since 1994, several abdominal procedures have been completed by using the needlescopic technique, but there appear to be no prospective studies to demonstrate the perceived benefits of needlescopic appendectomy. The authors compared open, laparoscopic, and needlescopic appendectomy in a randomized fashion with regard to duration of surgery, length of hospitalization, analgesic dosage, and surgery-associated complications. From March to July 1998, 75 patients admitted at the emergency station of the authors' hospital with a final diagnosis of acute appendicitis without tumor formation were randomized to receive one of the three treatment categories: open (OA), laparoscopic (LA), and needlescopic (nLA) appendectomy. Laparoscopic and needlescopic appendectomy were performed by using a three-port technique, although the size of the trocar used varied. There were 26 patients in the OA group, 23 in the LA group, and 26 in the nLA group. The mean operation durations for the OA, LA, and nLA groups were 55.4 ± 28.0 minutes, 69.1 ± 48.8 minutes, and 62.3 ± 26.3 minutes, respectively, and these were not significantly different from one another. The mean number of the analgesic doses (Pethidine 1 mg/kg) required was 1.3 ± 1.2 mg/kg, 0.5 ± 0.8 mg/kg, and 0.2 ± 0.6 mg/kg, respectively. Significant differences were noted when comparing the OA with the LA or nLA groups (OA vs. LA, P = 0.02; OA vs. nLA, P = 0.0002; LA vs. nLA, P = 0.06). The mean oral intake durations were 32.2 ± 16.9 hours, 21.0 ± 14.6 hours, and 20.8 ± 16.4 hours, respectively, after surgery for the OA, LA, and nLA groups, and the between-group differences were statistically significant for the OA versus LA group (P = 0.004) and for the OA versus nLA group (P = 0.003). The mean durations of hospitalization for the OA, LA, and nLA groups were 3.6 ± 1.8 days, 2.8 ± 1.4 days, and 2.4 ± 0.9 days, and difference was detected between the OA and the nLA groups (P = 0.02). The OA group rendered a greater wound-complication rate and ileus than did the other two groups, but the differences were not detected between the three categories (P = 0.065, 0.6935). The result of the current study confirmed that the nLA procedure is a feasible and safe one. The nLA procedure provided substantial advantages over the OA procedure in the contexts of diminished postoperative pain and shorter hospital stay without significant increases in postoperative complication rate or surgical time.

AB - The benefits of laparoscopic appendectomy appear to be controversial. Since 1994, several abdominal procedures have been completed by using the needlescopic technique, but there appear to be no prospective studies to demonstrate the perceived benefits of needlescopic appendectomy. The authors compared open, laparoscopic, and needlescopic appendectomy in a randomized fashion with regard to duration of surgery, length of hospitalization, analgesic dosage, and surgery-associated complications. From March to July 1998, 75 patients admitted at the emergency station of the authors' hospital with a final diagnosis of acute appendicitis without tumor formation were randomized to receive one of the three treatment categories: open (OA), laparoscopic (LA), and needlescopic (nLA) appendectomy. Laparoscopic and needlescopic appendectomy were performed by using a three-port technique, although the size of the trocar used varied. There were 26 patients in the OA group, 23 in the LA group, and 26 in the nLA group. The mean operation durations for the OA, LA, and nLA groups were 55.4 ± 28.0 minutes, 69.1 ± 48.8 minutes, and 62.3 ± 26.3 minutes, respectively, and these were not significantly different from one another. The mean number of the analgesic doses (Pethidine 1 mg/kg) required was 1.3 ± 1.2 mg/kg, 0.5 ± 0.8 mg/kg, and 0.2 ± 0.6 mg/kg, respectively. Significant differences were noted when comparing the OA with the LA or nLA groups (OA vs. LA, P = 0.02; OA vs. nLA, P = 0.0002; LA vs. nLA, P = 0.06). The mean oral intake durations were 32.2 ± 16.9 hours, 21.0 ± 14.6 hours, and 20.8 ± 16.4 hours, respectively, after surgery for the OA, LA, and nLA groups, and the between-group differences were statistically significant for the OA versus LA group (P = 0.004) and for the OA versus nLA group (P = 0.003). The mean durations of hospitalization for the OA, LA, and nLA groups were 3.6 ± 1.8 days, 2.8 ± 1.4 days, and 2.4 ± 0.9 days, and difference was detected between the OA and the nLA groups (P = 0.02). The OA group rendered a greater wound-complication rate and ileus than did the other two groups, but the differences were not detected between the three categories (P = 0.065, 0.6935). The result of the current study confirmed that the nLA procedure is a feasible and safe one. The nLA procedure provided substantial advantages over the OA procedure in the contexts of diminished postoperative pain and shorter hospital stay without significant increases in postoperative complication rate or surgical time.

KW - Acute appendicitis

KW - Laparoscopic appendectomy

KW - Needlescopic appendectomy

UR - http://www.scopus.com/inward/record.url?scp=0034780653&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034780653&partnerID=8YFLogxK

U2 - 10.1097/00019509-200110000-00004

DO - 10.1097/00019509-200110000-00004

M3 - Article

C2 - 11668227

AN - SCOPUS:0034780653

VL - 11

SP - 306

EP - 312

JO - Surgical Laparoscopy and Endoscopy

JF - Surgical Laparoscopy and Endoscopy

SN - 1530-4515

IS - 5

ER -