{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T07:23:01Z","timestamp":1792135381007,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T00:00:00Z","timestamp":1658620800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T00:00:00Z","timestamp":1658620800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T00:00:00Z","timestamp":1658620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Laparoscopic appendectomy (LA) has become the standard of care for the management of acute appendicitis in adult patients. Despite the increasing experience in laparoscopy, conversion to open surgery might still occur. We aimed to identify preoperative and intraoperative risk factors for conversion and determine surgical outcomes in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective analysis of a consecutive series of patients undergoing LA during the period 2006\u20132020. The cohort was divided into two groups: patients who underwent a fully laparoscopic appendectomy (FLA) and patients who were converted to open appendectomy (CA). Demographics, perioperative variables and postoperative outcomes were compared between both groups. Independent risk factors for conversion were determined by logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2193 patients were included for analysis; 2141 (98%) underwent FLA and 52 (2%) CA. Conversion rates decreased significantly over time (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). Patients with CA had significantly higher overall postoperative morbidity rates (FLA 14.9% vs. CA 48.0%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) and longer mean length of hospital stay (FLA 1.7 vs. CA 5\u00a0days). In the multivariate analysis, obesity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), previous abdominal operations (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), peritonitis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and complicated appendicitis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were independent risk factor for conversion.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although conversion from laparoscopic to open appendectomy is infrequent and has decreased over time, it is associated with significantly higher postoperative morbidity. Patients with previous abdominal operations, obesity and complicated appendicitis should be thoroughly advised about the higher risk of conversion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-022-06670-2","type":"journal-article","created":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T17:02:12Z","timestamp":1658682132000},"page":"2642-2647","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Conversion from Laparoscopic to Open Appendectomy: Trends, Risk Factors and Outcomes. A 15\u2010Year Single\u2010Center Analysis of 2193 Adult Patients"],"prefix":"10.1002","volume":"46","author":[{"given":"Manuela","family":"Monrabal Lezama","sequence":"first","affiliation":[{"name":"Department of Surgery Hospital Alem\u00e1n of Buenos Aires 1640 Pueyrredon Ave Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda A.","family":"Casas","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital Alem\u00e1n of Buenos Aires 1640 Pueyrredon Ave Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian A.","family":"Angeramo","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital Alem\u00e1n of Buenos Aires 1640 Pueyrredon Ave Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Bras Harriott","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital Alem\u00e1n of Buenos Aires 1640 Pueyrredon Ave Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Schlottmann","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital Alem\u00e1n of Buenos Aires 1640 Pueyrredon Ave Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115734"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010017\u20104123\u20103"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010010\u20100669\u2010z"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2017.03.016"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.9738\/INTSURG\u2010D\u201013\u201000058.1"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.4293\/108680809X1258998404524"},{"issue":"11","key":"e_1_2_7_8_1","first-page":"CD001546","article-title":"Laparoscopic versus open surgery for suspected appendicitis","volume":"11","author":"Jaschinski T","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S41571"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072\u20107515(01)01164\u20104"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2015.06.089"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/110241501750099438"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2018.09.033"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010017\u20103869\u2010y"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010020\u201007448\u20100"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003225"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.13201"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12893\u2010019\u20100578\u20105"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010012\u20101550\u2010z"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181fc9d53"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/109264204322862270"},{"key":"e_1_2_7_22_1","unstructured":"PushpanathanNR HashimMNM ZahariZet al. Conversion rate and risk factors of conversion to open in laparoscopic appendicectomy.Ann Coloproctol(2021)10.3393\/ac.2020.00437.006234407370"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11806"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEG.S196471"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010019\u201051172\u20102"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481307900930"},{"key":"e_1_2_7_27_1","doi-asserted-by":"crossref","unstructured":"AngeramoC LaxagueF CastagninoBet al. Impact of obesity on surgical outcomes of laparoscopic appendectomy: lessons learned from 2000 cases in an urban teaching hospital.Surg Laparosc Endosc Percutan Tech(2021)10.1097\/SLE.000000000000091434406166","DOI":"10.1097\/SLE.0000000000000914"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010006\u20109027\u20105"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-022-06670-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00268-022-06670-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-022-06670-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-022-06670-2","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T12:06:48Z","timestamp":1703333208000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-022-06670-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,24]]},"references-count":27,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1007\/s00268-022-06670-2"],"URL":"https:\/\/doi.org\/10.1007\/s00268-022-06670-2","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,24]]},"assertion":[{"value":"4 July 2022","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 July 2022","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Manuela Monrabal Lezama, Mar\u00eda A. Casas, Cristian A. Angeramo, Camila Bras Harriott and Francisco Schlottmann have no conflict of interest, financial ties or funding\/support to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}