Apendicectomía transumbilical escalonada vs laparoscópica

Abstract

The surgeon’s thought in his surgical evolution, always tries to give the best for the benefit of his patients. And even more so with the current concepts of minimally invasive surgery, which using the umbilical scar can develop the transumbilical appendectomy. It is an alternative to be used by the trained and skilled surgeon, leaving an abdominal wall without anatomical, physiological sequelae and with an excellent aesthetic result. Objective: To compare the effectiveness of transumbilical staggered appendectomy versus laparoscopic appendectomy considered today as the gold standard in patients with acute and / or complicated appendicitis through certain variables such as surgical time, hospital stay and postoperative complications. Material and methods: retrospective, descriptive and crosssectional study, conducted at the Maria Auxiliadora Hospital (HMA) from January 2014 to January 2017. Statistical method used was the SPSS version 22 and Chi square tests x2. Results: 1977 patients were included, 56.85% (n = 1124) are male and 43.14% (n = 853) are female, of which transumbilical appendectomy was performed in 58.42% (n = 1155) and laparoscopic appendectomy in: 41.57% (n = 822). When comparing both techniques in relation to surgical time, hospital stay and complications, significant differences are found. Conclusions: Despite the statistical differences, but taking into account that the laparoscope is not always available or there is lack of surgical skills, we reccomend to perform the transumbilical surgical approach in acute or complicated appendicitis because it is safe, easy to perform and alternative with aesthetic results identical or similar to laparoscopic appendectomy.