Randomized controlled trials have shown that laparoscopic surgery for simple appendicitis has a smaller incidence of incisional infection, a shorter hospital stay, and a faster recovery than open surgery. However, there are no relevant randomized controlled studies for complicated appendicitis. For this reason, Professor Thomson JE et al. conducted a randomized controlled study of laparoscopic (LA) and open (OA) surgery for complicated appendicitis, which was published on October 16, 2014, in Surg Endosc. The study divided 114 patients with complicated appendicitis into LA and OA groups by computerized random assignment, which was approved by the World Medical Association Ethics Committee, and all participants signed an informed consent form. Complicated appendicitis included appendicitis with physical examination, biochemical and imaging studies suggesting limited or diffuse peritonitis that could cause surgical casualty. Patients younger than 12 years of age, pregnant women, and those with a history of abdominal surgery were excluded. The primary outcomes of the study were all-cause mortality and surgery-related mortality, and the secondary outcomes were in terms of duration of surgery, incision infection rate, secondary surgery rate, length of hospital stay, and readmission rate. Those with postoperative pathology suggestive of normal or simple appendicitis will be further excluded. The statistical results showed that there was no significant difference between laparoscopic surgery (LA) and open surgery (OA) for complicated appendicitis in terms of operative time, incision infection rate, secondary operation rate, hospitalization time and re-hospitalization rate, which proved that LA surgery was equally safe and effective in the treatment of complicated appendicitis. In conclusion, laparoscopic surgery (LA) for complicated appendicitis is as safe and effective as open abdominal surgery (OA), but the present study is limited by the sample size, and a large sample of RCTs is needed to support the ability of LA surgery to reduce postoperative complications and hospitalization time.