Laparoscopic versus open appendectomy: a prospective comparative study

  • Sumita Pradhan Tribhuvan University Teaching Hospital . Maharajganj, Kathmandu , Nepal.

Abstract

Introduction:  Appendectomy is one of the most commonly performed surgeries usually done by conventional open method. The role of laparoscopic appendectomy is still not well defined in the literature and although widely practiced it still hasn’t gained popularity in Nepal.  The aim of this study was to compare the outcomes of laparoscopic versus open appendectomy.Methods: A prospective study was carried out, between August 2013 and September 2014, involving 216 patients (93 males and 123 females) with a diagnosis of acute appendicitis based on Alvarado score of seven and above. Patients were allocated into two groups where every alternate patient was operated either open or laparoscopically. The groups were compared in terms of operative time, post operative pain, post operative complications and length of hospital stay.Results: Open appendectomy (OA) comprised of 106 patients and Laparoscopic appendectomy (LA) comprised of 110 patients. Patients’ characteristics were similar in both groups. The mean operative time in LA was 42.82±10.84 minutes and in OA 37.99±9.81 minutes (p<0.86). Conversion was done in 2.8% of laparoscopic cases. Mean comparison of postoperative pain by visual analogue scale was low in LA compared to OA (P<0.05). Mean post operative stay (3.19±1.26 vs 2.75±0.7, p<0.01) and surgical site infection was recorded in 9 patients (8.5%) in OA group and 3 (2.5%) in LA group, with p value of 0.06. Conclusions:  Laparoscopic appendectomy is feasible and safe as open procedure with less post operative pain and shorter hospital stay.

Author Biography

Sumita Pradhan, Tribhuvan University Teaching Hospital . Maharajganj, Kathmandu , Nepal.
Department of Surgery Institute of Medicine,

References

1. Semm K. Endoscopic appendectomy. Endoscopy. 1983; 15: 59–64.
2. Ioannis Kehagias, Stavros Nikolaos Karamanakos, Spyros Panagiotopoulos, Konstantinos Panagopoulos, Fotis Kalfarentzos.Laparoscopic versus open appendectomy: Which way to go? World J Gastroenterol 2008; 14: 4909-14.
3. Alvarado A: A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 1986, 15:557-64.
4. Creese PG. The first appendectomy. Surg Gynecol Obstet. 1953;97:643
5. Sauerland S, Lefering R, Neugebauer EAM. Laparoscopic versus open surgery for suspected appendicitis. The Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD001546. DOI: 10.1002/14651858.CD001546.
6. Frazee RC, Roberts JW, Symmonds RE, et al. A prospective randomized trial comparing open versus laparoscopic appendicectomy. Ann Surg 1994; 219:725-31.
7. Temple LK, Litwin DE, McLoid RS. A meta-analysis of laparoscopic versus open appendectomy in patients suspected of having acute appendicitis. Can J Surg.1999;42:377-83
8. Minutolo, Vincenzo, et al. "Outcomes and cost analysis of laparoscopic versus open appendectomy for treatment of acute appendicitis: 4-years experience in a district hospital." BMC surgery 14.1 (2014): 1.
9. Chung RS, Rowland DY, Li P, Diaz J. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg 1999; 177:250–6.
10. Liu SI, Siewert B, Raptopoulos V, Hodin RA. Factors associated with conversion to laparotomy in patients undergoing laparoscopic appendectomy. J Am Coll Surg. 2002; 194:298–305.
11. Martin LC, Puente I, Sosa JL, et al. Open versus laparoscopic appendectomy. A prospective randomized comparison. Ann Surg. 1995; 222:256–61.
12. Batajoo H, Hajra NK. Laparoscopic versus open appendectomy in acute appendicitis. J Nepal Health Res Counc 2012; 10:239-42.
13. Chiarugi M, Buccianti P, Celona G, Decanini L, Martino MC,Goletti O, et al. Laparoscopic compared with open appendectomy for acute appendicitis: a prospective study. Eur J Surg. 1996; 162:385–90.
14. Lujan Mompean JA, Robles Campos R, Parrilla Paricio P, SoriaAldeo V, Garcia Ayllon J. Laparoscopic versus open appendicectomy: a prospective assessment. Br J Surg. 1994; 81:133–5.
15. Tate JJ. Laparoscopic appendectomy. Br J Surg. 1996 Sep; 83(9):1169-70.
Published
2017-08-10
How to Cite
PRADHAN, Sumita. Laparoscopic versus open appendectomy: a prospective comparative study. J Soc Surg Nep, [S.l.], v. 18, n. 2, p. 29-32, aug. 2017. ISSN 2392-4772. Available at: <http://jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=214>. Date accessed: 24 feb. 2021.
Section
Original Article

Keywords

acute appendicitis; laparoscopic appendectomy; open appendectomy