OUTCOMES OF LAPAROSCOPIC SURGERY FOR ACUTE APPENDICITIS IN ADULTS AND THE ELDERLY: A LITERATURE REVIEW

Abstract

Introduction: Acute appendicitis is a leading cause of acute surgical abdomen and emergency interventions in adults and the elderly. Laparoscopic appendectomy has become an established alternative to open surgery, offering a less invasive approach, improved visualization of the abdominal cavity, and a potential reduction in postoperative complications. However, in the elderly, physiological changes, comorbidities, and atypical clinical presentations can lead to delayed diagnosis and a higher incidence of complicated cases, making it important to evaluate the outcomes of this approach in this population. Objective: To analyze scientific evidence regarding the outcomes of laparoscopy in the treatment of acute appendicitis in adults and the elderly, considering safety, complications, and postoperative recovery. Methods: This is a narrative literature review conducted using the PubMed, SciELO, Virtual Health Library (VHL/BVS), and LILACS databases. Studies published between 2019 and 2025 in Portuguese and English that addressed laparoscopic appendectomy in adult and elderly patients were included. Findings were qualitatively analyzed regarding key perioperative outcomes. Results: Evidence indicates that laparoscopy yields favorable results in treating acute appendicitis, including a lower incidence of surgical site infections, reduced postoperative pain, shorter hospital stays, and an earlier return to daily activities. In the elderly, these benefits are particularly significant due to their increased vulnerability to complications associated with invasive procedures and prolonged hospitalization. The technique also facilitates exploration of the abdominal cavity and differential diagnosis. However, complicated appendicitis, clinical instability, and multiple comorbidities may increase the risk of complications and necessitate a tailored approach. Conclusion: Laparoscopy is a safe and effective approach for treating acute appendicitis in appropriately selected adults and elderly patients. Its benefits regarding postoperative recovery and the reduction of certain complications reinforce its relevance, although the decision to operate must take into account age, clinical condition, the team's experience, and the severity of the disease.