Laparoscopic Versus Open Appendectomy Plus Peritoneal Lavage for Acute Complicated Appendicitis Patients With Diffuse Peritonitis

Laparoscopic Versus Open Appendectomy Plus Peritoneal Lavage for Acute Complicated Appendicitis Patients With Diffuse Peritonitis: A Single-center Retrospective Study

This study aim to evaluate the efficacy and safety of laparoscopic versus open appendectomy in the treatment of acute complicated appendicitis with diffuse peritonitis.

Appendicitis is defined as inflammation of the vermiform appendix and worldwide is the most common reason for emergency abdominal surgery. Globally, the annual incidence is 96.5 to 100 cases per 100 000 adult population. For acute uncomplicated appendicitis, antibiotic therapy has emerged as the primary treatment, often allowing patients to avoid surgery. However, the management of acute complicated appendicitis requires careful consideration of various treatment options.

Complicated appendicitis, characterized by peri-appendiceal phlegmon or abscess formation, presents additional challenges and often requires a more comprehensive treatment approach. Management strategies have evolved to incorporate both conservative and surgical treatments, tailored to the patient's condition. However, for Acute complicated appendicitis with diffuse peritonitis, surgery is the only option. Acute complicated appendicitis with diffuse peritonitis is a severe abdominal emergency that often requires prompt surgical intervention. Traditionally, open appendectomy has been the standard approach. In recent years, laparoscopic appendectomy has gained popularity due to its minimally invasive nature and potential for faster recovery. Despite this, the optimal surgical approach for complicated appendicitis with diffuse peritonitis remains debated, particularly regarding the risk of postoperative complications and recovery outcomes. The primary aim of this study is to compare the efficacy and safety of laparoscopic versus open appendectomy in such cases, focusing on postoperative complications, hospital stay, and other factors influencing surgical outcomes.

Inclusion Criteria:

Patients aged 18 or older;

Patients with diffuse peritonitis caused by a perforated appendix confirmed intraoperatively;

Patients who underwent emergency appendectomy with peritoneal lavage;

Patients who had postoperative pathological confirmation of acute appendicitis.

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Exclusion Criteria:

Patients younger than 18 years;

Patients have a history of prior malignancies;

Patients with incomplete clinical or pathological records.