Title: Open Versus Laparoscopic Appendicectomy- A Comparative Study
Authors: Dr Tanmay Mehta, Dr H.V. Nerlekar
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.92
Abstract
Background: Laparoscopic appendicectomy has rapidly become established as the popular alternative to open appendicectomy, it has a safety profile better than open procedure.
Objectives: Laparoscopic procedure for appendicectomy is compared with open surgical technique with respect to:
· Duration of procedure.
· Post operative pain.
· Duration of analgesic use.
· Complication encountered
· Post operative length of hospital stay.
· Conversion to open appendectomy
Methods: Prospective study from December 2008 to May 2010, involved 50 patients with diagnosis of acute or recurrent appendicitis was entered into a study randomizing the choice of operation to either the open or the laparoscopic technique. Statistical comparisons were performed using the chi-square test and students ‘t’ test.
Results: 25 patients were assigned to the laparoscopic appendicectomy group and 25 patients were assigned to the open appendicectomy group. There were statistically significant difference noted in respect to postoperative pain (LA, 1.21 ± 0.63 Vs. OA, 2.72±0.87: P<0.001) duration of analgesic used (LA,2.2 ± 1.08 Vs. OA, 6.44 ± 1.84:P<0.001) postoperative complications like vomiting [LA, 2 (8%) Vs. O.A, 7 (28%), fever [LA, 1 (4%) Vs. OA, 4 (16%), wound infection [LA, 1 (4% Vs. OA, 5 (20%), ileus (LA, 17.3 ± 7.1 Vs. OA, 30.8±8.9:P<0.001) postoperative length of hospital stay (LA,2.8±1.23 Vs. OA, 7.7±1.95:P<0.001) and return to normal work (LA,13.5±2.86 Vs.OA, 20.8 ± 3.21:P<0.01) .Although above mentioned advantage were at the cost of slightly increased duration of surgery (LA,71.2 ± 19.23 Vs.OA,53.8 ± 20.04:P<0.01).
Conclusions: The patients who underwent laparoscopic appendicectomy had less postoperative pain and shorter duration of analgesic use, less postoperative complications like vomiting, fever ileus and wound infection with shorter postoperative duration of hospital stay and return to normal work when compared with patients who underwent open appendicectomy. Laparoscopic appendicectomy is better than open appendicectomy in selected patients with acute or recurrent appendicitis.
Keywords: Appendicectomy, Laparoscopic appendicectomy, Open appendicectomy, Acute appendicitis.
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