Articles T67 Số CDD10 - HN Bệnh viện Nhi Đồng 2 - HN Trường Đại học Nguyễn Tất Thành

ĐÁNH GIÁ HIỆU QUẢ VÀ AN TOÀN CỦA PHẪU THUẬT NỘI SOI ĐIỀU TRỊ VIÊM RUỘT THỪA Ở BỆNH NHÂN TRÊN 80 TUỔI TẠI BỆNH VIỆN THỐNG NHẤT

Ho Huu Duc1,2,3,4, Nguyen Van Hung5,6, Do Duy Dat1,3, Ho Le Bao1,3
1 Thong Nhat Hospital
2 Nguyen Tat Thanh University
3 Bệnh viện Thống Nhất
4 Trường Đại học Nguyễn Tất Thành
5 University of Health Sciences, Vietnam National University, Ho Chi Minh City
6 Trường Đại học Khoa học Sức khoẻ, Đại học Quốc gia TP. Hồ Chí Minh
DOI: 10.52163/yhc.v67icd10.6189
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Keywords
appendicitis; laparoscopic surgery; elderly patients; postoperative complications.
Abstract

Objective: To evaluate the efficacy and safety of laparoscopic appendectomy in patients aged ≥80 years at Thong Nhat Hospital, and to identify factors associated with postoperative complications.

Methods: A cross-sectional descriptive study was conducted on 52 patients aged 80 years or older who were diagnosed with acute appendicitis and underwent laparoscopic appendectomy between January 2020 and October 2025. Data were collected from medical records and analyzed using SPSS version 26.0.

Results: The mean age was 84.1 ± 3.1 years, and 58% were male. The mean operative time was 79 ± 22 minutes, with a conversion to open surgery rate of 11.5%. The overall postoperative complication rate was 25%, with 8% classified as Clavien–Dindo grade III–IV. There were no intraoperative or postoperative deaths. Exploratory univariable analyses suggested that appendiceal perforation and conversion to open surgery were associated with a higher occurrence of postoperative complications.

Conclusion: Laparoscopic appendectomy in patients aged ≥80 years is safe and effective, with low morbidity and no mortality. Careful preoperative assessment and optimal management of risk factors are essential to improve surgical outcomes.

References
[1]
Lapsa S, Ozolins A, Strumfa I, et al. Acute appendicitis in the elderly: A literature review on an increasingly frequent surgical problem. Geriatrics (Basel). 2021;6(3):93. doi:10.3390/geriatrics6030093. Google Scholar
[2]
Wang D, Dong T, Shao Y, Gu T, Xu Y, Jiang Y. Laparoscopy versus open appendectomy for elderly patients: A meta-analysis and systematic review. BMC Surg. 2019;19(1):57. doi:10.1186/s12893-019-0515-7. Google Scholar
[3]
Southgate E, Vousden N, Karthikesalingam A, Markar SR, Black S, Zaidi A. Laparoscopic vs open appendectomy in older patients. Arch Surg. 2012;147(6):557–62. doi:10.1001/archsurg.2012.38. Google Scholar
[4]
Kim MJ, Fleming FJ, Gunzler D, Messing S, Monson JR. Laparoscopic appendectomy is safe and efficacious for the elderly: An analysis using the National Surgical Quality Improvement Project database. Surg Endosc. 2011;25(6):1802–7. doi:10.1007/s00464-010-1467-2. Google Scholar
[5]
Stevens A, Marx CK, Danziger J, et al. Age is associated with increased morbidity after laparoscopic appendectomy. Medicine (Baltimore). 2022;101(20):e29325. doi:10.1097/MD.0000000000029325. Google Scholar
[6]
Ferrarese AG, Pozzi G, Borghi F, et al. Laparoscopic appendectomy in the elderly: our experience. BMC Surg. 2013;13(Suppl 2):S22. doi:10.1186/1471-2482-13-S2-S22. Google Scholar
[7]
Biondi A, Di Stefano C, Ferrara F, Bellia A, Vacante M, Piazza L. Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness. World J Emerg Surg. 2016;11:44. doi:10.1186/s13017-016-0102-5. Google Scholar
[8]
Jaschinski T, Mosch C, Eikermann M, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2018;11(11):CD001546. doi:10.1002/14651858.CD001546.pub4. Google Scholar
[9]
Kirshtein B, Bayme M, Domchik S, Mizrahi S, Lantsberg L, Korzets Z. Value of laparoscopic appendectomy in the elderly patient. World J Surg. 2009;33(5):981–5. doi:10.1007/s00268-009-9960-1. Google Scholar
[10]
Shaikh AR, Sangrasi AK, Shaikh GA. Clinical outcomes of laparoscopic versus open appendectomy. J Soc Laparoendosc Surg. 2009;13(4):574–80. doi:10.4293/108680809X12589998404199. Google Scholar