Perbandingan Luaran Apendektomi Terbuka dan Apendektomi Laparoskopi pada Pasien Apendisitis di Asia
DOI:
https://doi.org/10.35790/msj.v8i1.61595Abstract
Abstract: Appendectomy is one of the treatments for appendicitis which can be done using either the open or laparoscopic approach. The choice of surgical technique is often determined by several factors such as medical expertise, availability of healthcare facilities, and patient-related factors. In Asia, with its diverse healthcare systems and population characteristics, the comparison of outcomes between these two techniques remains underexplored. This study aimed to compare the outcomes of both methods in appendicitis patients, focusing on studies conducted in Asia. This was a literature review study using articles searched on PubMed and Google Scholar databases. Comparative analysis of outcomes between both methods was performed descriptively. The results obtained a total of 48 articles that met the inclusion and exclusion criteria. Laparoscopic appendectomy had a significantly shorter hospital stay and lower postoperative pain compared to open appendectomy. However, in terms of postoperative complications, inconsistencies were found in the literature due to various factors. In conclusion, laparoscopic appendectomy is superior to open appendectomy in terms of shorter hospital stays and lower levels of postoperative pain. However, regarding postoperative complications, neither method showed a significant advantage over the other.
Keywords: open appendectomy; laparoscopic appendectomy; appendicitis
Abstrak: Apendektomi adalah salah satu tatalaksana apendisitis yang dapat dilakukan dengan metode terbuka atau laparoskopi. Pemilihan teknik pembedahan sering kali ditentukan oleh faktor seperti keahlian medis, ketersediaan fasilitas kesehatan, dan faktor pasien. Di Asia, dengan sistem kesehatan dan karakteristik populasi yang beragam, perbandingan luaran kedua teknik ini masih kurang dieksplorasi. Penelitian ini bertujuan untuk membandingkan luaran kedua metode pada pasien apendisitis, dengan fokus pada penelitian yang dilakukan di Asia. Penelitian ini merupakan suatu literature review dari artikel-artikel yang ditelusuri pada database PubMed dan Google Scholar. Analisis perbandingan luaran kedua metode dilakukan secara deskriptif. Hasil penelitian mendapatkan sebanyak 48 artikel memenuhi kriteria inklusi dan eksklusi. Apendektomi laparoskopi memiliki durasi rawat inap yang lebih singkat dan nyeri pasca operasi yang lebih ringan secara bermakna dibandingkan apendektomi terbuka. Dalam hal komplikasi pasca operasi, ditemukan adanya inkonsistensi dalam literatur yang disebabkan oleh berbagai macam faktor. Simpulan penelitian ini ialah apendektomi laparoskopi lebih unggul dibandingkan apendektomi terbuka dalam hal durasi rawat inap dan tingkat nyeri pasca operasi. Namun, dalam hal komplikasi pasca operasi, tidak ada metode yang menunjukkan keunggulan bermakna dibandingkan metode lainnya.
Kata kunci: apendektomi terbuka; apendektomi laparoskopi; apendisitis
References
Goldman L, Schafer AI. Goldman’s Cecil Medicine (24th ed). Philadelphia: Elsevier Saunders; 2012.
Wijaya W, Eranto M, Alfarisi R. Perbandingan jumlah leukosit darah pada pasien appendisitis akut dengan appendisitis perforasi. Jurnal Ilmiah Kesehatan Sandi Husada [Internet]. 2020;11(1):341–6. Available from: https://doi.org/10.35816/jiskh.v11i1.288
Becker P, Fichtner-Feigl S, Schilling D. Clinical management of appendicitis. Visc Med [Internet]. 2018;34(6):453–8. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6341313/
Nikolov NK, Reimer HT, Sun A, Bunnell DB, Merhavy ZI. Open versus laparoscopic appendectomy: a literature review. J Mind Med Sci [Internet]. 2024;11(1):4-9. Available from: https://doi.org/10.22543/2392-7674.1472
Lin KB, Chan CL, Yang NP, Lai RK, Liu YH, Zhu SZ, et al. Epidemiology of appendicitis and appendectomy for the low-income population in Taiwan, 2003-2011. BMC Gastroenterol [Internet]. 2015;15:18. Available from: https://doi.org/10.1186/s12876-015-0242-1
Basukala S, Thapa N, Bhusal U, Shrestha O, Karki S, Regmi SK, et al. Comparison of outcomes of open and laparoscopic appendectomy: a retrospective cohort study. Health Sci Rep [Internet]. 2023;6(8):e1483. Available from: https://doi.org/10.1002/hsr2.1483
Rao AD, Tan CBD, Singaporewalla RM. laparoscopic appendectomy translates into less analgesics and faster return to work in Asia. JSLS [Internet]. 2022;26(2):e2022.00006. Available from: https://doi.org/10.4293/JSLS.2022.00006
Shaikh AH, Tandur AE, Sholapur S, Vangal G, Bhandarwar AH, Ghosh A, et al. Laparoscopic versus open appendectomy: a prospective comparative study and 4-year experience in a tertiary care hospital. Surg J (NY) [Internet]. 2022;8(3):e208–14. Available from: https://doi.org/10.1055/s-0042-1751112
Shankar O, Balraj N, Tatikonda V. A comparative study of appendicectomy: open and laparoscopic. Asian Pac J Health Sci [Internet]. 2016;3(1):168–74. Available from: https://doi.org/10.21276/apjhs.2016.3.1.28
Akhtar N, Shahid F, Naz S, Ijaz RM, Asif M, Jameel MA. Comparison of the outcome of laparoscopic vs open appendectomy in tertiary care hospital of Muzaffarabad. PJMHS [Internet]. 2022;16(4):147–9. Available from: https://doi.org/10.53350/pjmhs22164147
Çiftçi F. Laparoscopic vs mini-incision open appendectomy. World J Gastrointest Surg [Internet]. 2015;7(10):267-72. Available from: http://dx.doi.org/10.4240/wjgs.v7.i10.267
Mirani SH, Ali MT, Kumar D, Abaidullah K, Zai AR, Memon MH. Comparison of laparoscopic and open appendectomy in terms of surgical site infection. PJMHS [Internet]. 2022;16(5):341–2. Available from: https://doi.org/10.53350/pjmhs22165341
Taguchi Y, Komatsu S, Sakamoto E, Norimizu S, Shingu Y, Hasegawa H. Laparoscopic versus open surgery for complicated appendicitis in adults: a randomized controlled trial. Surg Endosc [Internet]. 2016;30(5):1705–12. Available from: https://doi.org/10.1007/s00464-015-4453-x
Shahid MH, Khan FI, Askri ZA, Asad A, Saeed R, Talib TB, et al. Two-year experiences of 500 appendectomies in Lahore General Hospital, Lahore. Cureus [Internet]. 2022;14(1):e21303. Available from: https://doi.org/10.7759/cureus.21303
Alkhalifah HA, Aljehani KM, Algethami SR, Alyahya SA, Alzubide AA, Alharbi RM, et al. Surgical and pre-surgical factors affecting appendectomy outcomes in Jeddah, Saudi Arabia: a retrospective record review. Cureus [Internet]. 2024;16(6):e62960. Available from: https://doi.org/10.7759/cureus.62960
Shimoda M, Maruyama T, Nishida K, Suzuki K, Tago T, Shimazaki J, et al. Comparison of clinical outcome of laparoscopic versus open appendectomy, single center experience. Heliyon [Internet]. 2018;4(5):e00635. Available from: https://doi.org/10.1016/j.heliyon.2018.e00635
Cheng HT, Wang YC, Lo HC, Su LT, Soh KS, Tzeng CW, et al. Laparoscopic appendectomy versus open appendectomy in pregnancy: a population-based analysis of maternal outcome. Surg Endosc [Internet]. 2015;29(6):1394–9. Available from: https://doi.org/10.1007/s00464-014-3810-5
Karaman E, Aras A, Çim N, Kolusari A, Kiziltan R, Çelik S, et al. Maternal and fetal outcomes after laparoscopic vs. open appendectomy in pregnant women: data from two tertiary referral centers. Ginekol Pol [Internet]. 2016;87(2):98–103. Available from: https://doi.org/10.17772/gp/58752
Segev L, Segev Y, Rayman S, Shapiro R, Nissan A, Sadot E. Appendectomy in pregnancy: appraisal of the minimally invasive approach. Journal of Laparoendoscopic and Advanced Surgical Techniques [Internet]. 2016;26(11):893–7. Available from: https://doi.org/10.1089/lap.2016.0280
Gök AFK, Soytaş Y, Bayraktar A, Emirikçi S, İlhan M, Koltka AK, et al. Laparoscopic versus open appendectomy in pregnancy: a single center experience. Ulusal Travma ve Acil Cerrahi Dergisi [Internet]. 2018;24(6):552–6. Available from: https://doi.org/10.5505/tjtes.2018.26357
Duan C, Li Y, Ma J, Song Y, Zhou L. The impact of laparoscopic appendectomy and open appendectomy on B7-H3-mediated intrinsic immune response in children with acute suppurative appendicitis. J Inflamm Res [Internet]. 2024;17:1577–87. Available from: https://doi.org/10.2147/jir.s446199
Liu Y, Cui Z, Zhang R. Laparoscopic versus open appendectomy for acute appendicitis in children. Indian Pediatr [Internet]. 2017;54(11):938–41. Available from: https://doi.org/10.1007/s13312-017-1186-z
Rehman HU, Naeem T, Bugti Q, Shah VES, Fayaz M, Rashid M. Open versus laparoscopic appendicectomy in pediatric patients; a comparative study in a single center. PJHS-Lahore [Internet]. 2022;3(6):253–6. Available from: https://thejas.com.pk/index.php/pjhs/article/view/371/236
Ali R, Anwar M, Akhtar J. Laparoscopic versus open appendectomy in children: a randomized controlled trial from a developing country. J Pediatr Surg [Internet]. 2018;53(2):247–9. Available from: https://doi.org/10.1016/j.jpedsurg.2017.11.022
Luo CC, Chien WK, Huang CS, Huang HC, Lam C, Hsu CW, et al. National trends in therapeutic approaches and outcomes for pediatric appendicitis: a Taiwanese nationwide cohort study. Pediatr Surg Int [Internet]. 2015;31(7):647–51. Available from: https://doi.org/10.1007/s00383-015-3718-8
Fujishiro J, Watanabe E, Hirahara N, Terui K, Tomita H, Ishimaru T, et al. Laparoscopic versus open appendectomy for acute appendicitis in children: a nationwide retrospective study on postoperative outcomes. J Gastrointest Surg [Internet]. 2021;25(4):1036–44. Available from: https://doi.org/10.1007/s11605-020-04544-3
Yang J, Yu K, Li W, Si X, Zhang J, Wu W, et al. Laparoscopic appendectomy for complicated acute appendicitis in the elderly: a single-center experience. Surg Laparosc Endosc Percutan Tech [Internet]. 2017;27(5):366–8. Available from: https://doi.org/10.1097/sle.0000000000000447
Dikicier E, Mantoğlu B, Özdemir K, Kamburoğlu MB, Gönüllü E. Laparoscopy versus open appendectomy for elderly patients: a single-center experience. Sakarya Med J [Internet]. 2021;11(1):1–8. Available from: https://doi.org/10.31832/smj.777166
Nazir A, Farooqi SA, Chaudhary NA, Bhatti HW, Waqar M, Sadiq A. Comparison of open appendectomy and laparoscopic appendectomy in perforated appendicitis. Cureus [Internet]. 2019;11(7):e5105. Available from: https://doi.org/10.7759/cureus.5105
Aziret M, Çetinkünar S, Erdem H, Kahramanca Ş, Bozkurt H, Dülgeroǧlu O, et al. Comparison of open appendectomy and laparoscopic appendectomy with laparoscopic intracorporeal knotting and glove endobag techniques: a prospective observational study. Turk J Surg [Internet]. 2017;33(4):258–66. Available from: https://doi.org/10.5152/turkjsurg.2017.3583
Mantoʇlu B, Karip B, Mestan M, Işcan Y, Aʇca B, Altun H, et al. Should appendectomy be performed laparoscopically? Clinical prospective randomized trial. Turk J Surg [Internet]. 2015;31(4):224–8. Available from: https://doi.org/10.5152/ucd.2015.2843
Pathania BS, Mir YAA. Comparative clinical study of complications associated with laparoscopic and open appendicectomy. Indian Journal of Basic and Applied Medical Research [Internet]. 2019;8(4):128–35. Available from: www.ijbamr.com
Hayat S, Riaz O, Usman M, Bilal Lodhi MF, Ahmad Khan A. Comparison of open versus laparoscopic appendectomy in terms of post operative pain and operative duration. Professional Med J [Internet]. 2019;26(10):1706–11. Available from: https://doi.org/10.29309/TPMJ/2019.26.10.3534
Ahirsang LS, Awati JS, Sharief SA. Laparoscopic versus open appendectomy: A comparison of primary outcome studies from North Karnataka. Al Ameen J Med Sci [Internet]. 2016;9(4):226–30. Available from: http://ajms.alameenmedical.org/ArticlePDFs/5%20AJMS%20V9.N4.2016%20p%20226-230.pdf
Khan A, Ali Shah A, Naseem Akhtar N, Ali Langah I, Ali A. Comparative outcomes of laparoscopic versus open appendectomy: a randomized controlled trial. Journal of Population Therapeutics & Clinical Pharmacology [Internet]. 2024;31(6):2166–72. Available from: https://doi.org/10.53555/jptcp.v31i6.6834
Akıncı O, Abdulrahman SMF, Güngör Ö. Mini-incision open appendectomy versus laparoscopic appendectomy: an experience in a rural hospital. Ulusal Travma ve Acil Cerrahi Dergisi [Internet]. 2021;27(3):310–4. Available from: https://doi.org/10.14744/tjtes.2020.83023
Alkhuzaie HF, Alhabib YY, Alanazi AF, Ali MI, Alqahtani AA, Noorelahi SK, et al. Challenges and ways for pain assessment of children in the primary health care. Int J Community Med Public Health [Internet]. 2021;8(2):895–9. Available from: https://dx.doi.org/10.18203/2394-6040.ijcmph20210016
Xiao Y, Shi G, Zhang J, Cao JG, Liu LJ, Chen TH, et al. Surgical site infection after laparoscopic and open appendectomy: a multicenter large consecutive cohort study. Surg Endosc [Internet]. 2015;29(6):1384–93. Available from: https://doi.org/10.1007/s00464-014-3809-y
Tseng CJ, Sun DiP, Lee IC, Weng SF, Chou CL. Factors associated with small bowel obstruction following appendectomy a population-based study. Medicine (Baltimore) [Internet]. 2016;95(18):e3541. Available from: https://doi.org/10.1097/md.0000000000003541
Takami T, Yamaguchi T, Yoshitake H, Hatano K, Kataoka N, Tomita M, et al. A clinical comparison of laparoscopic versus open appendectomy for the treatment of complicated appendicitis: historical cohort study. Eur J of Trauma Emerg Surg [Internet]. 2020;46(4):847–51. Available from: https://doi.org/10.1007/s00068-019-01086-5
Sultan AI, Ali SH, Habash MM. Comparison of open versus laparoscopic appendectomy in patients with acute appendicitis in terms of postoperative complications. J Res Med Dent Sci [Internet]. 2022;10(7):267–70. Available from: https://www.researchgate.net/publication/363032200
Chung WS, Chen YP, Chen W, Lin CL. Incidence and risk of venous thromboembolism in patients following appendectomy: a nationwide cohort study. J Thromb Thrombolysis [Internet]. 2019;48(3):483–90. Available from: https://doi.org/10.1007/s11239-019-01890-1
Yoo KC, Park JH, Pak KH, Kim KY, Lee BH, Kim BC, et al. Could laparoscopic appendectomy in pregnant women affect obstetric outcomes? A multicenter study. Int J Colorectal Dis [Internet]. 2016;31(8):1475–81. Available from: https://doi.org/10.1007/s00384-016-2584-8
Tan WJ, Pek W, Kabir T, Hoong Chan W, Keong Wong W, Soo Ong H. Clinical outcome and cost comparison between laparoscopic and open appendicectomy. Ann Acad Med Singap [Internet]. 2014;43(9):464–8. Available from: https://pubmed.ncbi.nlm.nih.gov/25341631/
Shen Z, Sun P, Jiang M, Zhen Z, Liu J, Ye M, et al. Endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy versus open appendectomy for acute appendicitis: a pilot study. BMC Gastroenterol [Internet]. 2022;22:63. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8842886/
Fayraq A, Alzahrani SA, Alsayaf Alghamdi AG, Alzhrani SM, Alghamdi AA, Abood HB. Risk factors for post-appendectomy surgical site infection in laparoscopy and laparotomy - retrospective cohort study. Cureus [Internet]. 2023;15(8):e44237. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10523175/
Al-Rbiehat HS, Al-Abbadi AM, Haddadin S, Aljarrah R. Laparoscopic versus open appendectomy: randomized study in king Hussien Medical Centre Amman/Jordan. Int J Med Invest [Internet]. 2014;3(4):133–6. Available from: http://www.intjmi.com/
Rasuli SF, Naz J, Azizi N, Hussain N, Qureshi PNAA, Swarnakari KM, et al. Laparoscopic versus open appendectomy for patients with perforated appendicitis. Cureus [Internet]. 2022;14(6):e26265. Available from: https://doi.org/10.7759/cureus.26265
Özozan ÖV, Güldoğan CE, Gündoğdu E, Özmen MM. Obesity and appendicitis: laparoscopy versus open technique. Turk J Surg [Internet]. 2020;36(1):105–9. Available from: https://doi.org/10.5578/turkjsurg.4714
Katar MK, Başer M, Ersoy PE. Appendectomy in patients with morbid obesity: laparoscopic versus conventional technique. Med Sci Monit [Internet]. 2020;26:e928067. Available from: https://doi.org/10.12659/msm.928067
Destek S, Kundakcioglu H, Bektasoglu HK, Kunduz E, Yigman S, Yabaci Tak A, et al. Comparison of open and laparoscopic techniques in the surgical treatment of acute appendicitis. North Clin Istanb [Internet]. 2023;10(6):704–10. Available from: https://doi.org/10.14744/nci.2022.08941
Nakashima M, Takeuchi M, Kawakami K. Clinical outcomes of acute appendicitis during pregnancy: conservative management and appendectomy. World J Surg [Internet]. 2021;45(6):1717–24. Available from: https://doi.org/10.1007/s00268-021-06010-w
Cai YL, Yang SS, Peng DZ, Jia Q Bin, Li FY, Ye H, et al. Laparoscopic appendectomy is safe and feasible in pregnant women during second trimester: a retrospective study in a top-level Chinese center. Medicine (Baltimore) [Internet]. 2020;99(33):E21801. Available from: https://doi.org/10.1097/md.0000000000021801
Kumar SS, Collings AT, Wunker C, Athanasiadis DI, DeLong CG, Hong JS, et al. SAGES guidelines for the use of laparoscopy during pregnancy. Surg Endosc [Internet]. 2024;38(6):2947–63. Available from: https://doi.org/10.1007/s00464-024-10810-1
Armughan M, Sadiq I, Mukhtar S, Altaf HA. Association of wound infection with various surgical technique applied for appendectomy in diabetic and hypertensive patients. PJMHS [Internet]. 2021;15(8):2163–5. Available from: https://doi.org/10.53350/pjmhs211582163
Güler Y, Karabulut Z, Çaliş H, Şengül S. Comparison of laparoscopic and open appendectomy on wound infection and healing in complicated appendicitis. Int Wound J [Internet]. 2020;17(4):957–65. Available from: https://doi.org/10.1111/iwj.13347
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Luna M. Soetarman, Angelica M. J. Wagiu, Stephanus J. C. Tangel
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
COPYRIGHT
Authors who publish with this journal agree to the following terms:
Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal.
Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal.
Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
