MASTERING THE LEARNING CURVE SIGNIFICANTLY REDUCES OPERATIVE TIME FOR LAPAROSCOPIC TREATMENT OF COMPLICATED APPENDICITIS
Journal
ARCHIVES OF PUBLIC HEALTH
Date Issued
2021-08-30
Author(s)
Otljanski, Aleksandar
Selmani, Rexhep
DOI
10.3889/aph.2021.6000
Abstract
Laparoscopic appendectomy is the preferred operative method for acute appendicitis treatment. In terms of complicated appendicitis it can be effective in hands of an experienced laparoscopist that overwhelmed the learning curve for the method. Aim: Тhis retrospective study examines whether the operative time for laparoscopic appendectomy for complicated appendicitis is shortened after mastering the learning curve. Material and methods: A total number of 196 patients were operated for the diagnosis of acute appendicitis, of whom 77 were diagnosed with complicated appendicitis. They were subsequently divided in two groups (laparoscopic and open). Operative time in both groups was measured and the conversion and postoperative complications were noted. Results: Conversion rate was 2.3%. Operative time was shorter in the laparoscopic group (67.4 ± 22.9 vs. 77.9 ± 17.9 minutes; p = 0.033). Overall postoperative morbidity was 25.97% with wound infection present only in the open group (p = 0.018). Intraabdominal abscess occurred in one patient from the laparoscopic group (0.38%). Length of hospital stay was shorter in the laparoscopic group (4.3 ± 2.2 vs. 5.7 ± 2.1, p = 0.0052).