Study on Laparoscopic Operation for Perforated Appendicitis

Far Eastern Memorial Hospital

Status

Unknown

Conditions

Perforated Appendicitis

Treatments

Procedure: Open appendectomy

Procedure: Laparoscopic appendectomy

Study type

Observational

Funder types

Other

Identifiers

NCT00677989

FEMH No. 96044

Details and patient eligibility

About

The purpose of this study is to conduct a prospective observational study for the open approach and laparoscopic approach for perforated appendicitis. It is also designed to investigate if carbon dioxide pneumoperitoneum will have unwanted effect when treating perforated appendicitis with laparoscopic operation.

Full description

The role of laparoscopic appendectomy (LA) for perforated appendicitis is under investigation. According to the results of a previous retrospective study conducted in Far-Eastern Memorial Hospital comparing the clinical outcomes between perforated appendicitis patients treated by laparoscopic and open approach showed favored clinical outcomes for LA. Same as a few studies indicated that laparoscopic appendectomy is a safe and effective procedure for treating patients with perforated appendicitis in terms of hospital stay and wound complications. One the other hand, some authors still concern about the adverse effects of laparoscopy for ruptured appendicitis patients in terms of longer operation time and increased rates of postoperative abscess formation. We hypothesize that prolonged CO2 pneumoperitoneum will produce transient mesenteric ischemic and reperfusion injury when CO2 disinflation, and the free radicals and oxidative proteins provoked by reperfusion injury are responsible for the adverse reaction of LA. The objective of this prospective non-randomized controlled study is to examine the safety and efficacy of laparoscopic appendectomy and compare its outcome with that of the conventional approach for perforated appendicitis patients, with special emphasis on postoperative complication and oxidative stress resulted from pneumoperitoneum..

Enrollment

60 estimated patients

Sex

All

Ages

12 to 80 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

All patients admitted at the emergency station of our hospital expressing pain other than the right lower abdominal quadrant.
The results of a clinical examination favored the diagnosis of perforated acute appendicitis, and the result of abdominal computed tomography revealed signs of acute appendicitis and intra-abdominal fluid accumulation.
Patients were accepted to our study only if perforated appendicitis remained as the most likely diagnosis of their condition and if they were between 12 from 80 years old with informed consent.

Exclusion criteria

Age less than 12 years
older than 80 years
perforated appendicitis was not revealed by pathologic investigation
diverticulitis being diagnosed during surgery
pelvic inflammatory disease or other gynecologic disease found during laparoscopic examination or diagnosed before operation
the patient declining to enroll in this study