Methods of improving results of surgery on acute appendicitis in case of retroperitoneal location of vermiform appendix

Abstract

The paper provides comparative analysis of the results of standard and optimized approach to performing surgery on acute appendicitis with retroperitoneal location of the vermiform appendix in 95 patients. In 1998-2002 the appendectomies through the laparotomy incision were performed, as a rule, without previously performed laparoscopy. With respect to the patients group with the optimized approach (2003-2011) the method of surgery was chosen, depending on the location of the appendix and the appendicitis-associated complications detected during the laparoscopy. The laparoscopy, laparoscopic and video-assisted appendectomy and post-operative sanitation laparoscopy were used as methods of optimization. The wide application of the optimized approach allowed in 84.4 % of cases to accurately diagnose, decrease the frequency of median laparotomies from 46.2 to 10.7 % of cases, and reduce the frequency of post-operative wound complications from 23.1 to 8.9 %.