Meta- Analysis to find out an ideal treatment for Acute appendicitis

Abstract

background: Open appendectomy (OA) was the standard procedure for inflamed appendix. First laparoscopic appendectomy (LA) was done in 1980 since then Laparoscopic Appendectomy has been gaining more popularity and approval despite the controversies that surrounding its safety and universal applicability.Aim: This is a comparative study to evaluate the safety, effectiveness and the superiority of LA vs OA in treating the acute appendicitis.Materials and methods: This retrospective study was performed by examining huge number of literatures and huge number of clinical observations regarding treatment of acute appendicitis after applying new parameters like patient selection, operating time, hospital stay, cost effectiveness, intra and postoperative complications, needs for painkillers, role of antibiotics, operative technique and cosmetic issues.Result: Large number of studies have showed that LA is highly beneficial for young age group females, it shortens the hospital stay time, minimizes the need for post- operative painkillers, and it bears good cosmetic outcome. On the other hand it carries serious complications, it is time consuming technique, and it impacts big financial burden. While antibiotics use and modifying the type of operative techniques can improve the overall outcome for both modalities.Discussion: This study has found that both laparoscopic and open appendectomy have some advantages and disadvantages, but logical evaluation of these outcomes clearly shows that, the LA impacts more serious and devastating complication, which may outweigh its benefits.Conclusion: By careful reviewing of all above parameters we can reach an important decision regarding the ideal approach for operating on acute appendicitis, such decision gives the superiority for the OA over the LA in treating acute appendicitis, especially in an attempt to avoid devastating complications.