Comparison of laparoscopic and open appendectomy for complicated appendicitis: Retrospective analysis of single centre experiences

Despite all the advances in laparoscopic surgery, it is still controversial whether complicated appendicitis should be treated by laparoscopic or open surgery. In this study, we aimed to compare intraoperative and postoperative outcomes of patients with complicated appendicitis who underwent laparoscopic or open appendectomy. Between March 2018 and March 2022, 151 patients underwent laparoscopic or open appendectomy for complicated appendicitis were analysed retrospectively. Demographic, laboratory data, and postoperative outcomes were examined. The median age of the patients was 46 years (interquartile range: 31-63) and 55% of the patients were male. Laparoscopic appendectomy was performed in 54.3% of the patients. While there was no significant difference observed in hospitalization durations between groups, laparoscopic appendectomy exhibited longer operation times compared to open appendectomy. Furthermore, postoperative follow-ups revealed a higher incidence of severe complications (Clavien-Dindo 3-4) in laparoscopic appendectomy (p=0.037). Subgroup analysis of complications indicated a greater frequency of intra-abdominal abscesses in laparoscopic procedures (p=0.033). Although the benefits of minimally invasive surgeries have been well-established, in cases of complicated appendicitis, we recommend open surgery over laparoscopic surgery to clinicians.