Appendectomy is a common surgical procedure performed to treat acute appendicitis, with two primary approaches: laparoscopic appendectomy (LA) and open appendectomy (OA). While both methods are widely utilized, there is ongoing debate about their relative efficacy, safety, and cost-effectiveness. This study aimed to compare the clinical outcomes, complications, recovery parameters, and cost-effectiveness of LA and OA to determine the optimal surgical approach. This study systematically reviewed 13 studies published between the years 2016 and 2024, encompassing prospective, retrospective, and interventional designs. A total of 2,490 patients (1396 underwent OA, and 1094 underwent LA) were included. Data on operative time, com plications, recovery parameters, and cost were extracted and analyzed, with a meta-analysis conducted to evaluate differences between LA and OA. The meta-analysis revealed that LA was associated with a longer operative time compared to OA, with a mean difference of 9.57 minutes (p-value = 0.067), though this was not statistically significant. LA demonstrated a significantly lower prevalence of wound infection, with a prevalence ratio of 0.241 (p-value = 0.001). Hospital stay duration was significantly reduced in LA, with a mean difference of −0.618 days (p-value = 0.001), and patients undergoing LA returned to normal activities much faster, with a mean difference of −5.405 days (p-value = 0.001). Although certain patient factors and clinical scenarios might necessitate OA, LA should be the preferred surgical method in most cases due to its favorable outcomes. Future studies are recommended to explore long-term outcomes and refine patient selection criteria for both approaches.
Key words: Comparative outcomes, laparoscopic, open surgery, appendicitis, systematic review
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