Benefits of Introduction of Laparoscopic Appendectomy in a Community Hospital: a Shorter Hospital Stay and Reduced Wound Infection 第36巻02号0121頁

Received: December 24, 2010/Accepted: March 1, 2011 Correspondence to: Kojiro Nakamura Department of Surgery, Graduate School of Medicine Kyoto University, 54 Kawahara-cho, Shogoin, Sakyoku, Kyoto 606-8507, Japan Abstract AIM: To investigate the benefits of introduction of laparoscopic appendectomy (LA) in a community hospital. PATIENTS AND METHODS: The subjects of the study were 56 patients who underwent appendectomy for acute appendicitis from June 2003 to January 2005 in Kokura Memorial Hospital. Before March 2004, all patients underwent open appendectomy (OA). We introduced LA in April 2004 and from that point onwards almost all the cases underwent LA, except for the initial few cases. Operating time, wound infection, postoperative fever, the time to the first flatus, time of use of postoperative analgesics, and the length of postoperative hospitalization were evaluated. RESULTS: Of the 56 patients enrolled in the study, 35 underwent OA and 21 underwent LA. The operating time for LA was longer than that for OA (mean ± S.D.: 81 ± 37 vs. 58 ± 21 min, p<0.01). However, the rate of wound infection was lower (37% vs. 0%, p<0.01), and the hospitalization was shorter (9.0 ± 6.1 vs. 5.7 ± 3.4 days, p<0.05) for LA. There were no significant differences in other factors. CONCLUSION: The introduction of LA into a community hospital can reduce wound infection and shorten hospitalization. Thus, we recommend use of LA in community hospitals.