I.S. Malkov1, T.A. Mamedov2, V.A. Filippov1, R.Z. Gilmutdinov2, I.I. Valiullin2

1Kazan State Medical Academy ― Branch Campus of the FSBEI FPE RMACPE MOH Russia, Kazan

2City Clinical Hospital №7, Kazan

Malkov Igor S. ― Doct. of Sci. (Med.), Professor, Head of the Department of Surgery of the Kazan State Medical Academy ― Branch Campus of the FSBEI FPE RMACPE MOH Russia

36 Butlerov Str., Kazan, 420012, Russian Federation, tel. +7-965-594-40-07, e-mail:, ORCID ID: 0000-0003-2350-5178, Scopus Author ID: 7003868993


Relevance. Treatment of complicated forms of acute destructive appendicitis continues to be an urgent problem of emergency abdominal surgery.

The aim of the study is to improve the results of surgical treatment of patients with a complicated form of acute appendicitis by using laparoscopic appendectomy.

Material and methods. A retrospective analysis of the treatment of 150 patients with acute appendicitis complicated by local and widespread peritonitis. Depending on the treatment tactics used, 2 groups of patients were identified. In the main group (64 patients), laparoscopic appendectomy was the leading method of treatment. In the comparison group (86 patients), traditional approaches were used, including open appendectomy from McBurney’s access in 72 (83,7%) patients and laparotomy for advanced peritonitis in 14 (16,4%).

Results. The analysis of the surgery methods used showed that in the main group, wound postoperative complications developed in 9 (14,1%) patients. In the comparison group, postoperative complications developed in 32 (37,2%) patients. With local non-delimited peritonitis, the total duration of hospitalization after laparoscopic appendectomy performed in 49 patients was 6,7±1,4 days, in 72 patients who underwent open appendectomy ― 8,6±2,1 days (p<0,05). With widespread peritonitis after laparoscopic appendectomy, sanitation and drainage of the abdominal cavity (15 cases), the duration of hospitalization was 8,2±2,7 days, in 14 patients, after laparotomy, appendectomy, sanitation and drainage of the abdominal cavity, intubation of the small intestine ― 12,4±1,3 days (p<0,05).

Conclusions. Laparoscopic appendectomy may be the operation of choice for complicated forms of acute appendicitis according to the developed indications.

Key words: acute appendicitis, periappendicular abscess, peritonitis, laparoscopic appendectomy.