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Language: search.filters.language.EnglishSubject: search.filters.subject.laparoscopic appendectomy

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    Laparoscopic revision of open appendectomy complicated by high-output colo-cutaneousfistula:acasereport
    (Oxford University Press and JSCR Publishing Ltd., 2025-12)
    ;
    Jankoski, Daniel
    ;
    Kostovska, Irena
    Colo-cutaneous fistulae are rare complications following appendectomy, especially when high-output, and can cause significant morbidity. We report a 66-year-old male who presented nine days post-open appendectomy with fecal discharge from the incision. Imaging showed cecal adherence to the anterior abdominal wall, consistent with a colo-cutaneous fistula. Conservative management failed, with persistent high-output drainage of 600–1000 mL/day. The patient underwent laparoscopic revision, including adhesiolysis, mobilization of the terminal ileum and ascending colon, and resection with extracorporeal ileocolic anastomosis. Postoperative wound healing was managed with secondary intention and negative pressure therapy. The patient recovered well and was discharged in stable condition. This case demonstrates the effectiveness of laparoscopic intervention in high-output colo-cutaneous fistulae and highlights the need for timely surgical management when conservative measures fail.
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    LAPAROSCOPIC AND OPEN APPENDECTOMY IN PEDIATRIC PATIENTS –OPERATIVE AND POSTOPERATIVE EXPERIENCE
    (2022-09)
    ;
    Rozeta Sokolova
    ;
    ;
    Risto Simeonov
    Objective: Acute appendicitis is very frequently encountered in children. Despite many scientific controversies in supporting classical or laparoscopic appendectomy, there is still no official consensus on this issue. This study aimed to present our experience from the comparison of operative and postoperative effects of laparoscopic and open appendectomy in pediatric patients with acute appendicitis. Materials and methods: The analytical cross-sectional study was conducted at the University Clinic for Pediatric Surgery, Ss. Cyril and Methodius University in Skopje, the Republic of N.Macedonia during the period 2015/2022. The study sample covered 184 hospitalized pediatric patients aged 4-14 years treated with laparoscopic (LA) or open appendectomy (OA). The data of interest included demographic characteristics, and selective operative and postoperative parameters. Results: The average age of the children in LA vs. OA group was 9.63±2.70 with min/max of 4/14 vs. 9.16±2.91 with min/max 2/14 respectively. Postoperative complications were detected in 1 (0.90%) of LA patients and 3 (4.11%) of OA patients with no significant association. Analgesics’ treatment received 57 (51.35%) of the children from LA group and all of the children from OA group. Conversion from LA to OA happen only in 1 (0.54%) child. The evaluation of parents/guardians related to the satisfaction from the cosmetic appearance of the scar the significantly higher level of satisfaction from the scare after LA compared to OA intervention. Conclusions: Laparoscopic appendectomy was found to be feasible and comparable to open approach in terms of operative time and offers advantages over the latter in terms of postoperative pain, length of hospital stay and earlier return of bowel function to normal. It is a safe approach in all types of appendicitis, with an overall better complication profile than OA.
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    RISING TREND OF USING LAPAROSCOPY IN THE TREATMENT OF COMPLICATED APPENDICITIS IN OUR INSTITUTION DURING JANUARY 2017-MAY 2019
    (Македонско лекарско друштво = Macedonian Medical Association, 2019)
    ;
    Gjorgji Stavridis
    ;
    Igor Fildishevski
    ;
    ;
    Abstract Introduction. Laparoscopic appendectomy was performed for the first time in the University Clinic for Surgery “St. Naum Ohridski” back in 2003 by the pediatric surgeons. At the moment it is still unrecognized by many senior surgeons as a reliable and safe alternative procedure for acute appendicitis. The end-point of this study is to present the rising trend of using laparoscopy in the treatment of complicated appendicitis. Methods. In the period between January 2017 and May 2019 a total number of 403 patients were operated on due to a preoperative diagnosis of acute appendicitis (270 with open and 133 with laparoscopic appendectomy) and were retrospectively analyzed. Results. Simple appendicitis was diagnosed intraoperatively in 248 patients and complicated appendicitis was diagnosed in 141 patients. The rising trend for overall use of laparoscopy for acute appendicitis was seen during the study period (20.9%, 32.2% and 63.3% in 2017, 2018 and 2019, respectively). In terms of complicated appendicitis, a drastic positive trend followed in favor of laparoscopy (8.9%, 24.6% and 36.7% in 2017, 2018 and 2019, respectively). The negative appendectomy rate with other intraoperative finding was 3.46% (14 cases). The conversion rate was 2.25%. Conclusion. We can finally conclude that the laparoscopic appendectomy is recognized as an effective and safe alternative in the treatment of complicated appendicitis in our institution.