Comparative systematic analysis of postoperative infection rates between laparoscopic and open appendectomy approaches

Acute appendicitis remains one of the most common surgical emergencies worldwide, requiring prompt intervention to prevent severe complications. This systematic review aimed to compare postoperative infection rates and recovery outcomes between laparoscopic and open appendectomy. A comprehensive search was conducted in databases such as PubMed, Scopus, and Web of Science, focusing on studies published in the last 11 years. Inclusion criteria encompassed clinical trials, cohort studies, and systematic reviews that evaluated postoperative complications, surgical site infections, and recovery metrics. Findings indicate that laparoscopic appendectomy is generally associated with lower rates of surgical site infections, shorter hospital stays, and faster recovery times compared to the open approach, particularly in adult and obese patient populations. However, evidence suggests that in cases of advanced appendicitis, laparoscopic surgery may increase the risk of intra-abdominal abscesses compared to the open method. Additionally, studies involving pediatric populations found no significant differences between the two techniques in terms of infection rates and postoperative complications. The review underscores that while laparoscopic appendectomy offers significant advantages in most scenarios, the choice of surgical technique should be tailored to individual patient profiles, considering factors such as appendicitis severity, comorbidities, and age. These findings highlight the importance of a personalized approach in surgical decision-making to optimize patient outcomes. Further research is recommended to explore long-term outcomes and refine strategies for managing high-risk cases, particularly in children and patients with complex appendicitis presentations.