Comparación de apendicectomía laparoscópica de puerto único con abordaje de 3 puertos en los Hospitales José Carrasco Arteaga y Vicente Corral Moscoso, 2013

Abstract

Acute appendicitis is the most common surgical disease in surgical services in first place of surgical acute abdomen. As minimally invasive surgery treatment is the best surgical approach. However it has ventured into less invasive and safer techniques such as single-port laparoscopic appendectomy.

Objective: compare the use of laparoscopic appendectomy single port with 3 ports in patients with acute appendicitis hospitals "Vicente Corral Moscoso" and "Jose Carrasco Arteaga".

Materials and method: an experimental study. We included 170 participants in the emergency department of hospitals “Vicente Corral Moscoso” and “Jose Carrasco Arteaga” underwent surgery for acute appendicitis; half were performed with single-port appendectomy and the other half were appendectomy performed with 3 ports.

Results: the most affected age group was 18-25 years, and the present male predominance in both groups. The operating time of 61-120 min was 61.2% in group 1, group 2 of 55.3%. The mild postoperative pain was presented in group 1 and 63.5% in group 2 was 41.2% mild , moderate 38.8%, with a hospital stay of 13-24 hours in the group 1 of 62 , 4% of group 2 unlike a prevalence of 25 to 36 hours 47.1%. Analyzing the behavior of the single port for less surgical time we found a RR of 0.71 (95% CI 0.4-1.2 ) , RRR 0.29 , NNT 15 RAR 0.07 , for pain intensity ( mild) RR of 1.54 (95% CI 1.1-2 ) , RRR -0.54 , -0.22 and NND RAR 5 and for shorter hospital stay ( less than 12 hours) 3.5 0.71 (CI 95% from 0.75 to 12.3 ) , -2.5 RRR , NNH 17 RAR 0.06.

Discussion: performing single-port laparoscopic appendectomies similar presents international research results, with regard to postoperative pain and hospital stay and is beneficial compared to 3 access ports. Conclusion: the realization of single-port laparoscopic appendectomy showed higher benefits in terms of postoperative pain and hospital stay.

Keywords: APPENDICITIS / THERAPY, APPENDICITIS / SURGERY, LAPAROSCOPY APPENDECTOMY / CLASSIFICATION, APPENDECTOMY / METHODS, POSTOPERATIVE PAIN / SURGERY, POSTOPERATIVE PAIN / CLASSIFICATION, REGIONAL “HOSPITAL VICENTE CORRAL MOSCOSO”, “JOSE CARRASCO ARTEAGA HOSPITAL” OF SOCIAL SECURITY INSTITUTE OF ECUADOR, CUENCA-ECUADOR.