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Category: Volume 06 Issue 06 June 2018
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Title: Laparoscopic or Open Appendectomy: A Surgical Dilemma

Authors: Chauhan A, Gangji A, Niranjan S

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i6.21

Abstract

Appendectomy is one of the most common surgical problems encountered in emergency with peak incidence between ages of 10 and 30 years. It is dealt nowadays with both laparoscopic and open approach. Because of lack of consensus about the best suitable technique, we aimed to compare the laparoscopic appendectomy with conventional open appendectomy in treatment of appendicitis. This prospective study was carried out in our department from May 2010 to April 2013. Total 184 patients of age group ranging from 14-60 years with features of acute appendicitis were divided into laparoscopic appendectomy and open appendectomy group. Laparoscopic surgery was done with 3 ports technique by creating pneumoperitoneum with CO2 and open appendectomy was done by Mc'Burney's incision. Data was analysed by student t-test and chi-square tests. Laparoscopic appendectomy though was little lengthy in intraoperative duration but resulted in shorter hospital stay, reduced analgesic usage, minimal general wound and related complications with early return to normal activity.

In future, with wider availability of laparoscopic equipments and experienced surgeons, laparoscopy will get more space amongst budding young surgeons for treatemnt of acute appendicitis.

References

  1. Semm k. endoscopic appendectomy. endoscopy. 1983;15;59-64.
  2. Sauerlend S, Jaschinski T, Neugebauer EA, Laparoscopic vs Open surgery for suspected appendicitis, Cochrane Database Syct Rev 2010;10.
  3. McBurney C. experience with early operative interference in cases of diseases of the vermiform appendix. NY state Med J50; 676,1889.
  4. McBurney CM. The incision made in abdominal wall in case of appendicitis with a description of a new method of operating. Ann Surg. 1894;20-38.
  5. Chung R.S. Rowland Dy, Li P, Diaz J. A meta – analysis of randomized controlled trial of laparoscopic versus conventional appendectomy. Am J Surg. 1999; 177: 250-256.
  6. Di SaverioS, Mandorioli M, Birindelli A, Biscardi A, Di Donato L. Gome CA, Diccini A, Vettoretto N, Agresta F, Tugnoli G, Jovine E. Single incision Laparoscopic Appendectomy with low cost technique and Surgical
  7. Glove port. “How to do it” with comparison of outcomes and costs in a consecutive single operator series of 45 cases. J Am coll. Surg. 2016; 222.7.
  8. Garbutt JM, Soper NJ , Shannon W, Botero A, Litten berg B. Meta analysis of randomized controlled trials comparing laparoscopic and open appendectomy. Surg. Laparosc endosc. 1999;9: 17-26.
  9. Fogli L, Brulatti M, Boschi S, Di DomenicoM, Papa V, Patrizi P, Capizzi FD Laparoscopic appendectomy for acute and recurrent appendicitis ; retrospective analysis of a single group 5 year experience, J Laparoendosc Adv Surg. Tech A. 2002; 12 : 107-110.
  10. Towfigh S, Chen F, Mason R, Katkhouda N, Chan L, Berne T Laparoscopic appendectomy significantly reduces length of stay for perforated appendicitis. Surg endosc. 2006; 20: 495-499.
  11. Milewoyk M, Miehalik M, Ciesielski M. A prospective randomized unicenter study comparing laparoscopic and open treatments of acute appendicitis. Surg. Endosc. 2003; 17: 1023-28.
  12. Olmi S, Magnone S, Bertolini A, Eroce E. Laparoscopic versus open Appendectomy in acute appendicitis: A randomized prospective study. Surg. Endosc. 2005;19: 1193-95.
  13. Shaikh AR, Sangrasi AK , Shaikh GA. Clinical outcome of Laparoscopic versus open Appendectomy. JSLS. 2009;13:574-580.
  14. Agresta F, De Simeone P, Leone L ArezzoA, Biondi A , Bottero L, et al. Italian society of Young surgeons (SPIGC). Laparoscopic Appendectomy in Italy: an appraisal of 26,863 cases. J Laparoendosc Adv. Surg Tech A. 2004; 14: 1-8
  15. Di Saverio S. Mandrioli M, Sibilio A, Smerieri N, Lombardi R catena F, Ansaloni L, Tognoli G, Masethi M, Jonine E. A cost effective technique for laparoscopic Appendectomy : Outcome and costs of a case control prospective single operator study of 112 unselected consecutive cases of complicated acute appendicitis. J Am coll surg. 2014:2018.
  16. Guller U. Hervey S Purves H. Muhlbaier LH, Peterson ED, Eubanks S, Pietroban R. Laparoscopic vs Open appendectomy : outcomes comparision based as a large administrative database. Ann Surg. 2004; 239.
  17. Merhoff CM, Merhoff GC, Flanklin ME, Laparoscope assisted extracorporeal versus open appendectomy ; AM J surg. 2006 ; 179 : 371-378.
  18. Ortega AE, Hunter JA, Peters JH, Swanstorm LL, Schirmer B A prospective randomized comparison of Laparoscopic appendectomy with open appendectomy. Laparoscopic appendectomy study group Am J Surg. 1995;169: 208-212.
  19. MooreDE, Speroff T, Grogan E, Poulose B , Holzman MD. Cost prospective of Laparoscopic and open Appendectomy. Surg endosc. 2005; 19:374-378
  20. Frazee RC, Roberts JW, Symmonds RE, et al. A prospective randomized trial comparing open versus laparoscopic appendectomy. An surg. 1994;219: 725-728.
  21. Merhoff CM, Merhoff GC, Flanklin ME, Laparoscope assisted extracorporeal versus open appendectomy ; AM J surg. 2006 ; 179 : 371-378.
  22. Ozmen MM, Zulfikaroglu B, Tanik A, Kare T, Laparoscopic versus open appendectomy ; Prospective randomized trial. Surg. Laprosc endosc. 1999; 9: 187-89.
  23. Hellberg A, Rudberg C, Kullman E. Prospective Randomized multicentric study of  laparoscopic versus open appendectomy, Br J Surg 1999; 86: 48-53.

Corresponding Author

Niranjan S

P.G. Resident, Department of Surgery

 G.R. Medical College, Gwalior (M.P.), India