[Laparoscopic or open appendectomy?]

[Laparoscopic appendicectomy in 2013--a barely tolerated procedure turning into a gold standard operation?]

INTRODUCTION

Laparoscopic appendectomy is one of the first developed minimally invasive surgical procedures, nevertheless its judgement is contradictory up to the present day as far as its advantages and indications are concerned.

METHODS

The authors of this article give an overview and analyse the relevant literature concerning laparoscopic appendectomy and the data of patients on whom appendectomy was performed from 01/01/2005 to 30/09/2013 with laparoscopic and open technique.

RESULTS

At the Surgical Department of the Uzsoki Hospital 1214 patients had appendectomy because of acute appendicitis from 01/01/2005 to 30/09/2013. The applied surgical procedure was laparoscopy with 1065 patients (87.73%) and the open technique with 149 patients (12.27%). Since January 2006 our main principle has been that in case of appendicitis the primary technique to be applied is laparoscopic appendectomy. We were forced to conversion with 16.5% of patients and as the operational experience of the department grows, the proportion of conversions tends to decrease.

CONCLUSION

The advantages of laparoscopic appendectomy as opposed to open surgery have become obvious in the past decade, and the procedure may be recommended for all age groups. In case acute appendicitis is suspected the primary procedure to be applied in our department is the laparoscopic operation, the results of which are at least as good as that of open appendectomy. The routine application of laparoscopic appendectomy provides an excellent basis for the acquisition of advanced laparoscopic surgery thus appendectomy will not lose its training character due to the laparoscopic approach.

[The role of Orvosi Hetilap in the development of contemporary Hungarian gastroenterology. Part 4: 1989-2008]

The editions of Orvosi Hetilap published between 1948 and 1989 easily exceeded the number of publications in the previous period. Most of the knowledge was transferred from English literature.

AIM

Evaluate the papers dealing with diseases of the gastrointestinal tract published in Orvosi Hetilap between 1989 and 2008.

METHOD

The author manually reviewed the journal volumes published between 1989 and 1208. The original articles, journal and book reviews were identified and classified according to their subject and origin. The publication rates of the editorial periods 1948-1989 and 1989-2008 were statistically compared.

RESULTS

Between 1989 and 2008 a total of 2817 publications appeared on the diseases of the gastrointestinal tract (1067 original articles, 1698 journal and 52 book reviews), constituting 10.1% of all publications. The annual rate of the original articles in the periods studied was similar (p = 0.82), while that of journal and book reviews decreased significantly (p = 0.006 and p = 0.01, respectively). The online version of Orvosi Hetilap and the English version of the journal, entitled Hungarian Medical Journal , became available from 2007. Liver (17.8%) and biliary tract diseases were studied the most (4.3%), especially viral hepatitis (7%). Laparoscopic surgery was studied in 27 articles (1.8%), while liver transplantation achieved a figure of 39 (2.6%). The genetics of gastrointestinal diseases were studied in 61 (4.0%) articles. 1,698 articles were reviewed from 131 journals, which constitutes a significant decrease as compared to the previous period. 65.4% of the reviews were published in 15 core journals. 62.4% of the journals were English, 31.5% were German and only 1.6% French, thus te previous dominance of the English literature was enhanced. The number of book reviews decreased from 211 to 52 (p = 0.01). The Hungarian experience in laparoscopic surgery was published in part in Orvosi Hetilap . The journal was the main forum for the articles on liver transplantation. After 2000, university research groups published their studies on the genetics of liver, inflammatory bowel diseases and other topics mainly in Orvosi Hetilap .

CONCLUSION

In the past two decades, Orvosi Hetilap successfully fulfilled its traditional role in providing professional information of Hungarian specialists and played a leading role in the adoption of new findings in the contemporary gastroenterology (laparoscopic surgery, liver transplantation, genetics).