A Systemic Review Comparing Laparoscopic Versus Open Appendectomy
Bibliographic record
Abstract
Background: Appendectomy remains the standard treatment for acute appendicitis, with laparoscopic appendectomy (LA) increasingly favored over open appendectomy (OA). However, debate persists regarding complication rates and outcomes, particularly in complicated appendicitis. Objective: To systematically review and synthesize evidence on the prevalence of postoperative complications following LA compared with OA, drawing on contemporary peer-reviewed literature. Methods: Following PRISMA 2020 guidelines, a systematic review was conducted across PubMed, Scopus, Web of Science, Embase, and Google Scholar. Eligible studies included randomized controlled trials, cohort studies, and meta-analyses published between 2000 and 2025, reporting complication prevalence after LA and/or OA. Outcomes of interest included surgical site infection, intra-abdominal abscess, operative time, hospital stay, and patient-reported measures. Quality assessment was performed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias tool. Results: Twenty-four studies met the inclusion criteria. LA was consistently associated with lower wound infection rates, shorter hospitalization, and faster return to normal activities. Intra-abdominal abscess rates were occasionally higher in complicated appendicitis treated laparoscopically, though recent randomized trials and national database studies suggest comparable safety profiles. Operative time was generally longer for LA, but this difference diminished in more recent studies. Patient-centered outcomes such as pain, cosmesis, and satisfaction favored LA, with strong benefits observed in obese patients and other high-risk groups. Conclusion: LA demonstrates clear advantages over OA in terms of wound-related complications, recovery, and patient satisfaction, establishing it as the preferred approach for appendectomy. Caution remains warranted in complicated appendicitis, where intra-abdominal abscess risk should be considered, and in contexts where conversion to OA is necessary.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.054 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.009 |
| Bibliometrics | 0.014 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".