Meta-analysis of randomized controlled trials comparing laparoscopic and open appendectomy

Jane M. Garbutt, Nathaniel J. Soper, William D. Shannon, Anna Botero, Benjamin Littenberg

Research output: Contribution to journalArticlepeer-review

157 Scopus citations


We performed a meta-analysis to determine whether laparoscopic or open appendectomy gives better outcomes for patients with suspected acute appendicitis. Studies were selected from the MEDLINE database, personal files, and meeting abstracts. Eleven of 21 randomized controlled trials were included in the meta-analysis. Pooled effect size estimates were calculated using a random effects model. Laparoscopic appendectomy reduced time to full functioning by 5.48 days (95% confidence interval [CI] 3.70 to 7.26; p < 0.001), improved postoperative pain at 24 hours measured by a visual analog scale from 0 to 10 by 1.19 points (95% CI -2.14 to -0.24 points; p = 0.014), and decreased the absolute risk for wound infection by 3.2% (95% CI-5.6% to - 0. 8%; p = 0.009). Operating time was increased by 17.12 min (95% CI 14.19 to 20.03; p < 0.0001). There was no difference between the two surgeries for length of hospital stay, readmission rate, and intra-abdominal abscess formation. Laparoscopic appendectomy improves patient outcomes.

Original languageEnglish
Pages (from-to)17-26
Number of pages10
JournalSurgical Laparoscopy and Endoscopy
Issue number1
StatePublished - 1999


  • Appendectomy
  • Controlled trials
  • Laparoscopy
  • Meta-analysis


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