급성 충수돌기염의 치료에서 복강경 절제술과 개복 절제술의 비교

Abstract

Many clinical studies had compared the outcomes of laparoscopic appendectomy for appendicitis with open appendectomy. Although most of them showed the advantages of laparoscopic surgery, some showed no advantage with laparoscopic appendectomy. The aim of this study was to compare the laparoscopic appendectomy with open appendectomy by analyzing the surgical outcomes and costs. We retrospectively analyzed the clinical outcomes of 153 patients who had undergone laparoscopic or conventional appendectomy between January 2003 and December 2005. The patients were divided into two groups, one for the laparoscopic appendectomy (LA) and another for open appendectomy (OA). The patients of each group was 87 for LA and 66 for OA. The mean age was 40.6 (±19.3) years in LA, 42.0 (±18.5) years in OA (p=0.701). The mean duration of hospital stay for the uncomplicated appendicitis was 3.5 (±3.3) days in LA, 4.2 (±2.6) days in OA. The hospital cost was 1,874,000 (±677,000) won in LA, 1,449,000 (±559,000) won in OA (p=0.001). Postoperative complication rate was same between two groups. The number of perforated appendicitis investigated in the pathologic finding of two groups was 10 and 12. The mean duration of hospital stay for the complicated appendicitis was 7.3 days in LA, and 7.4 days in OA (p=0.969). The hospital cost of perforated group was 2,141,000 (±922,000) won in LA, and 2,345,000 (±932,000) won in OA (p=0.223). The postoperative complication rate was similar between two groups. There was no statistical difference in demographic findings, hospital stay, and complication rate between two groups. However hospital cost of the laparoscopic and open appendectomy for uncomplicated appendicitis was higher in LA, but higher in OA for the complicated appendicitis.