Comparative epidemiological analysis between open appendectomy and laparoscopic appendectomy in Brazil from 2013 to 2023: Ecological study

Abstract

Introduction: Acute appendicitis, an inflammatory process of the vermiform appendix, is characterized as a surgical emergency, mainly due to its causal potential for the acute abdomen. Surgery to remove the vermiform appendix is ​​the most common in the world. Called appendectomy, this surgery can be performed open, laparoscopically and robotically. The videolaparoscopic modality has gained prominence in recent years, due to its characteristics and benefits. Methodology: An ecological, retrospective, quantitative study was carried out on hospitalizations resulting from appendectomy and laparoscopic appendectomy in Brazil from 2013 to 2023. The data were obtained from the SUS Hospital Information System (SIH/SUS), through the Department of Informatics of the Unified Health System (DATASUS), in July 2024. Data were collected separately for appendectomy and laparoscopic appendectomy. The variables selected for both were related to region, federation unit, year of processing, average length of stay and deaths. Results: During the period evaluated, a total of 1,167,139 hospitalizations were found resulting from appendectomy, and 78,027 from laparoscopic appendectomy. The videolaparoscopic approach had the highest number of cases in 2023, corresponding to 16.6%, while the open approach had the highest number in 2019, with 9.84% of the total. The Southeast had the highest number of hospitalizations resulting from open appendectomy among Brazilian regions. Videolaparoscopic surgery was most commonly performed in the South region, with a total of 60 deaths due to this modality. Furthermore, videolaparoscopic management exhibited a lower average length of stay when compared to open management.