The aim of the study is improvement of treatment results of patients with acute appendicitis by application of laparoscopic technique in diagnosis and treatment of the disease.
The laparoscopic diagnosis of acute appendicitis allows to avoid “unnecessary” appendectomy inevitable in traditional clinical and laboratory diagnosis. Performance of laparoscopic appendectomies for acute appendicitis is possible in 95.9% of patients. Intracorporal laparoscopic appendectomy was performed in 704 patients. We withdrew patients from the study if conversion to open appendectomy was necessary (28 patients — 4.0%). The appendix stump closure method was assigned in accordance with appendix base inflammatory changes. The patients were divided into 4 groups according to stump securing method. The appendix stump was controlled by using two or three titanic clips in 356 (52.6%) patients, two separate ligatures — in 252 (37.3%) patients, using a linear stapler in 56 (8.3%), and immersion into the ceacum cupola by a purse-string suture was performed in 12 (1.8%) patients. Operation time and complications were analyzed.
Duration of laparoscopic appendectomy — (53.4±7.6) min does not differ from open surgery — (49.2±8.7) min. Duration of in-hospital treatment after laparoscopic appendectomy — (3.4±0.9) days is shorter than after open surgery — (6.2±1.2) days. The rate of postoperative complications after laparoscopic appendectomy is lower than those after traditional open surgery — 3.5 and 6.1% accordingly.