***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Background A prospect i ve study including 272 patients with suspected appendicitis was performed . The aims were to evaluate the representativity of the study group and to compare diagnostic and therapeutic laparoscopy with conventional appendicectomy Abstract . A prospect i ve , r and omized trial was performed to compare open appendectomy with laparoscopic appendectomy  in men with a clinical diagnosis of acute appendicitis . Sixty-four patients with a median age of 25 years ( range 18–84 years ) were r and omized to open appendectomy ( n = 31 ) or laparoscopic ( n = 33 ) appendectomy . Of the 64 men , 56 ( 87.5 % ) had appendicitis ( 27 open , 29 laparoscopic procedures ) .  The mean operating times were 50.6 ± 3.7 minutes ( ± SEM ) for open and 58.9 ± 4.0 minutes for laparoscopic appendectomy ( p = 0.13 ) . Five ( 15 % ) patients r and omized to laparoscopic appendectomy had an open operation . The mean postoperative hospital stay was significantly longer for open appendectomy ( 3.8 ± 0.4 days ) than for laparoscopic appendectomy ( 2.9 ± 0.3 days ) ( t = 2.05,df = 62,p = 0.045 ) . The complication rate after open appendectomy ( 25.8 % ) was not significantly different from that after laparoscopic appendectomy ( 12.1 % ) . There was a single postoperative death due to a pulmonary embolus in the laparoscopic group and a single death due to cardiac and renal failure in the open group . The mean time to return to normal activities was significantly longer following open appendectomy ( 19.7 ± 2.4 days ) than after laparoscopic appendectomy ( 10.4 ± 0.9 days ) , ( t = 3.75,df = 49,p = 0.001 ) . In conclusion , laparoscopic appendectomy  in men has significant advantages in terms of a more rapid recovery compared to open appendectomy . There were no significant disadvantages to laparoscopic appendectomy compared to open appendectomy Aim : To see whether laparoscopy improves the accuracy of a clinical diagnosis of acute appendicitis in women of reproductive age , and to determine what the long-term sequelae are of not removing an appendix deemed at laparoscopy to be normal . Method : The initial part of the study was undertaken during 1991–1992 . Female patients between 16 and 45 years were eligible for inclusion once a clinical decision had been made to perform an appendicectomy for suspected acute appendicitis . Following consent , patients were r and omized into two groups . One group had open appendicectomy , as planned . The other group had laparoscopy , followed by open appendicectomy only if the appendix was seen to be inflamed or was not visualized . The end points for the study were the clinical outcomes of all patients , and the results of histology , where appropriate . An attempt was made to contact all patients at 10 years to determine whether they had had a subsequent appendicectomy , or had been diagnosed with another abdominal condition that might be relevant to the initial presentation in 1991–1992 . Results : Laparoscopic assessment was correct in all cases in which the appendix was visualized . Diagnostic accuracy was improved from 75 % to 97 % . Laparoscopy was associated with no added complications , no increase in hospital stay in patients who went on to appendicectomy , and a reduction in hospital stay for those who underwent laparoscopy alone . No patients developed a problem over the 10-year follow-up period from having a normal-looking appendix not removed at laparoscopy . Conclusion : Laparoscopic assessment of the appendix is reliable , and to leave a normal-looking appendix at laparoscopy does not appear to cause any long-term problems INTRODUCTION The aim of the study is to analyse the own data and try to discuss if laparoscopic appendectomy offers any advantages in treating young women suffering from pain in right lower abfdominal quadrant . MATERIAL S AND METHODS The study was conducted on 148 patients admitted from October 1993 to December 1998 with diagnosis of of pain in right iliac fossa and operated on with a laparoscopic ( LA group : 75 cases ) or open approach ( OA group : 73 cases ) . Patients were prospect ively r and omized on the surgical approach adopted , following a r and omized list . RESULTS The operative time in LA group was significantly ( p < 0.001 ) longer ( 87.2 minutes ) than for OA group ( 65.2 minutes ) . In 2 patients ( 2.7 % ) the operation had to be converted . Diagnosis had remained unknown in 16 patients ( 21.9 % ) of OA group , in spite of only one case ( 1.4 % ) with laparoscopic technique . We did n't observed intraoperative complications . Pain in the first and second postoperative days , evaluated on the use of pain medication , was significantly less in patients in group LA ( p < 0.01 ) . There were no deaths . Postoperative complications occurred in 4 patients ( 5.5 % ) of group LA , and in 8 patients ( 10.9 % ) of group OA . Hospital stay was significantly shorter for those having laparoscopic appendectomy ( p < 0.001 ) . DISCUSSION The main advantages of laparoscopic appendectomy consist more in diagnostic accuracy , than in less postoperative pain , less hospital stay and less postoperative complications . CONCLUSION Laparoscopic appendectomy is a safe and accurate approach The benefits of laparoscopic appendectomy appear to be controversial . Since 1994 , several abdominal procedures have been completed by using the needlescopic technique , but there appear to be no prospect i ve studies to demonstrate the perceived benefits of needlescopic appendectomy . The authors compared open , laparoscopic , and needlescopic appendectomy in a r and omized fashion with regard to duration of surgery , length of hospitalization , analgesic dosage , and surgery-associated complications . From March to July 1998 , 75 patients admitted at the emergency station of the authors ' hospital with a final diagnosis of acute appendicitis without tumor formation were r and omized to receive one of the three treatment categories : open ( OA ) , laparoscopic ( LA ) , and needlescopic ( nLA ) appendectomy . Laparoscopic and needlescopic appendectomy were performed by using a three-port technique , although the size of the trocar used varied . There were 26 patients in the OA group , 23 in the LA group , and 26 in the nLA group . The mean operation duration s for the OA , LA , and nLA groups were 55.4 ± 28.0 minutes , 69.1 ± 48.8 minutes , and 62.3 ± 26.3 minutes , respectively , and these were not significantly different from one another . The mean number of the analgesic doses ( Pethidine 1 mg/kg ) required was 1.3 ± 1.2 mg/kg , 0.5 ± 0.8 mg/kg , and 0.2 ± 0.6 mg/kg , respectively . Significant differences were noted when comparing the OA with the LA or nLA groups ( OA vs. LA , P = 0.02 ; OA vs. nLA , P = 0.0002 ; LA vs. nLA , P = 0.06 ) . The mean oral intake duration s were 32.2 ± 16.9 hours , 21.0 ± 14.6 hours , and 20.8 ± 16.4 hours , respectively , after surgery for the OA , LA , and nLA groups , and the between-group differences were statistically significant for the OA versus LA group ( P = 0.004 ) and for the OA versus nLA group ( P = 0.003 ) . The mean duration s of hospitalization for the OA , LA , and nLA groups were 3.6 ±1.8 days , 2.8 ± 1.4 days , and 2.4 ± 0.9 days , and difference was detected between the OA and the nLA groups ( P = 0.02 ) . The OA group rendered a greater wound-complication rate and ileus than did the other two groups , but the differences were not detected between the three categories ( P = 0.065 , 0.6935 ) . The result of the current study confirmed that the nLA procedure is a feasible and safe one . The nLA procedure provided substantial advantages over the OA procedure in the context s of diminished postoperative pain and shorter hospital stay without significant increases in postoperative complication rate or surgical time BACKGROUND Laparoscopic appendectomy is feasible , but whether it confers any advantage to patients with acute appendicitis is not known . We performed a r and omized controlled trial to compare results of laparoscopic and open appendectomy in patients with signs and symptoms suggesting acute appendicitis who were seen by one surgical team . METHODS Sixty-two consecutive patients were r and omized , 30 to laparoscopy and 32 to a classical open appendectomy .  Postoperative recovery , complications , and return to normal activities were compared in the two groups . RESULTS The laparoscopy group were discharged earlier ( 2.5 vs 3.8 days , p less than 0.01 ) . Postoperative complications were more frequent after open appendectomy . Follow-up showed less pain , shorter bed stay at home , and faster return to work and sport after laparoscopic appendectomy . CONCLUSIONS This prospect i ve r and omized study shows that laparoscopic appendectomy is superior to open appendectomy in terms of hospital stay , postoperative complications , and return to normal activities and is recommended as the approach of choice in the management of acute appendicitis Hyperkalaemia with ECG changes had been noted during prolonged carbon dioxide pneumoperitoneum in pigs . We have compared plasma potassium concentrations during surgery in 11 patients allocated r and omly to undergo either laparoscopic or open appendectomy and in another 17 patients allocated r and omly to either carbon dioxide pneumoperitoneum or abdominal wall lifting for laparoscopic colectomy .  Despite an increasing metabolic acidosis , prolonged carbon dioxide pneumoperitoneum result ed in only a slight increase in plasma potassium concentrations , which was both statistically and clinical ly insignificant . Thus hyperkalaemia is unlikely to develop in patients with normal renal function undergoing carbon dioxide pneumoperitoneum  for laparoscopic surgery Background The aim of this study was to study the value of diagnostic laparoscopy prospect ively in fertile women scheduled for acute appendectomy . Methods For this study , 110 women , with acute abdominal pain ages 15 to 47 years , in whom the surgeon had decided to perform an appendectomy  , were r and omized to either open appendectomy or diagnostic laparoscopy , then open appendectomy if necessary . Results Appendicitis was diagnosed in 66 % of the women after open surgery , and in 73 % after laparoscopy . During laparoscopy , was appendicitis misdiagnosed in only 7 % of the women , from whom the appendix unnecessarily removed , whereas 34 % in the open surgery group had a healthy appendix removed . No appendicitis was missed in the laparoscopic group . The relative risk of removing a healthy appendix in open surgery was 6.6 relative risk ( range , 2–21 C.I. ) as compared with laparoscopy . Among the women with a healthy appendix , a gynecologic diagnosis was found in 73 % after laparoscopy , as compared with 17 % after open surgery . Conclusions Laparoscopy reduces unnecessary appendectomies and improves diagnosis in fertile women BACKGROUND Laparoscopic appendectomy has now gained wider acceptance in clinical practice , particularly in the treatment of women with right iliac fossa pain . However , the precise role of laparoscopic appendectomy in men is unclear , and this study was therefore undertaken to examine this specific issue in a prospect i ve r and omized trial . METHODS One hundred men between the ages of 16 and 65 years who had suspected appendicitis were recruited and r and omized to undergo either open or laparoscopic appendectomy . Both groups were compared in terms of their clinical parameters , duration of anesthetic and operation times , postoperative pain , duration of ileus , and length of hospital stay . RESULTS The histologic confirmation of appendicitis was present in 94 % of the cases for both groups of patients . Laparoscopic appendectomy required significantly longer anesthetic time ( 72.5 minutes versus 55 minutes ) and actual operating time ( 45 minutes versus 25 minutes ) compared with open appendectomy .  Postoperative pain as measured by visual analog scale on postoperative days 1 and 2 were not significantly different between the patients who underwent laparoscopic and open surgery with values of 4.7 versus 4.4 and 2.1 versus 2.2 , respectively . Also no significant difference was seen between the laparoscopic and open appendectomy groups in the recovery of bowel function ( 24.7 hours versus 21 hours ) and in the length of hospital stay ( 4.9 days versus 5.3 days ) . CONCLUSIONS The results of this prospect i ve r and omized trial showed that there were no significant advantages of laparoscopic appendectomy over open appendectomy for the treatment of male patients with suspected appendicitis . We recommend that the use of laparoscopy 
    Output:
    
We found that  laparoscopy in women with acute lower abdominal pain , non-specific lower abdominal pain or suspected appendicitis led to a higher rate of specific diagnoses being made and a lower rate of removal of normal appendices compared with open appendicectomy only .
Hospital stays were shorter .
No evidence showed an increase in adverse events when any of these strategies were used