Annals of Coloproctology

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Original Article

Benign diesease & IBD,Biomarker & risk factor,Minimally invasive surgery

Conversion rate and risk factors of conversion to open in laparoscopic appendicectomy: Nelson Rao Pushpanathan, Mohd Nizam Md Hashim, Zalina Zahari, Syed Hassan Syed Abd. Aziz, Wan Zainira Wan Zain, Rosnelifaizur Ramely, Michael Pak-Kai Wong, Ikhwan Sani Mohamad, Wan Mokhzani Wan Mokhter, Maya Mazuwin Yahya, Siti Rahmah Hashim Isa Merican, Zaidi Zakaria, Andee Dzulkarnaen Zakaria; Ann Coloproctol. 2022;38(6):409-414. Published online August 18, 2021; DOI: https://doi.org/10.3393/ac.2020.00437.0062

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Purpose
Laparoscopic appendicectomy (LA) has several advantages over conventional open appendicectomy (OA). However, about 5% to 10% of LA patients still need to be converted to open surgery. Identifying risk factors that contribute to conversion to OA allows for early identification of patients who may benefit from primary OA. This study aimed to determine the conversion rate of LA to OA and to identify its associated risk factors among patients with acute or perforated appendicitis.
Methods
A retrospective review of medical records was performed among patients with acute or perforated appendicitis who underwent LA between December 2015 and January 2017. With the use of multivariable logistic regression analyses, the predictors of conversion from laparoscopic to OA were investigated.
Results
Out of 120 patients, 33 cases were converted to OA which gives a conversion rate of 27.5%. Among 33 patients who were converted to OA, 27 patients (81.8%) had perforated appendix, while in the LA group, perforated appendix cases consisted of 34.5% (P<0.001). Histopathology of the appendix was the predictor of conversion from LA to OA (adjusted odds ratio, 8.82; 95% confidence interval, 3.13–24.91; P<0.001).
Conclusion
The result from our study shows that the overall conversion rate for the study period was high. Patients with perforated appendicitis had a higher risk of conversion to OA. Therefore, preoperative diagnosis of perforated appendicitis may be paramount in predicting conversion to OA.

Citations

Citations to this article as recorded by

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Asian Journal of Surgery.2025; 48(1): 62. CrossRef
Laparoscopic appendectomy as the gold standard: What role remains for open surgery, conversion, and disease severity?
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Controversies and Future Directions in Management of Acute Appendicitis: An Updated Comprehensive Review
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Journal of Clinical Medicine.2024; 13(11): 3034. CrossRef
Comparison of Clinical, Pathological, and Procedural Characteristics of Adult and Pediatric Acute Appendicitis before and during the COVID-19 Pandemic
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Risk Factors for Conversion from Laparoscopic to Open Appendectomy
Bruno Leonardo Bancke Laverde, Matthias Maak, Melanie Langheinrich, Stephan Kersting, Axel Denz, Christian Krautz, Georg F. Weber, Robert Grützmann, Maximilian Brunner
Journal of Clinical Medicine.2023; 12(13): 4299. CrossRef
Risk of Conversion from Laparoscopic Appendectomy to Open Surgery: The Role of Clinical and Radiological Factors in Prediction
Nihan Turhan, Cengiz Duran, Taha Yusuf Kuzan, Beyza Nur Kuzan, Elbrus Zarbaliyev
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Manuela Monrabal Lezama, María A. Casas, Cristian A. Angeramo, Camila Bras Harriott, Francisco Schlottmann
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