Abstract
Introduction: Laparoscopic appendectomy and open appendectomy are the two methods of choice for appendectomy, the acceptance of laparoscopy over laparotomy still remaining a dogma. The specific aim was to compare the outcomes of both the methods in a district hospital setup.
Methods: A non-randomized interventional study was performed in a district hospital for a period of 1 year and follow up period of 3 months in the post op period at regular intervals after 1week, 4 weeks and 12 weeks post-op.
Statistical Analysis Used: The data was entered into a Microsoft Excel spreadsheet and then analyzed using the SPSS 20.0.1 and Graph Pad Prism version 5.
Results: Lesser hospital stay, intra and post-op analgesia, post-op pain, smaller scars and earlier ambulation, post-op feed and recovery in case of laparoscopic appendectomy as compared to open appendectomy.
Conclusion: Superiority of laparoscopic appendectomy over open appendectomy and can undoubtedly be the surgery of choice for both acute and recurrent acute appendicitis in a district level setup in India with better training, manpower and cost effectiveness.
Keywords: Laparoscopy, appendectomy, open, district hospital.
References
- McBurney C: The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg. 1894, 20: 38-43
- Peiser JG, Greenberg D: Laparoscopic versus open appendectomy: results of a retrospective comparison in an Israeli hospital. Isr Med Assoc J.2002 Feb, 4(2): 91-4
- Guller U, Hervey S, Purves H, Muhlbaier LH, Peterson ED, Eubanks S, Pietrobon R: Laparoscopic versus open appendectomy: outcomes comparison based on a large administrative. Ann Surg. 2004 Jan, 239(1): 43-52
- Padankatti L R, Pramod R K, Gupta A, Ramachandran P: Laparoscopic versus open appendectomy for complicated appendicitis: A prospective study. J Indian Assoc Pediatr Surg 2008; 13: 104-6
- Sauerland S, Jaschinski T, Neugebauer EA: Laparoscopic versus open surgery for suspected appendicitis. Chochrane Database Syst Rev. 2010 Oct.6, (10): CD001546
- Tiwari MM1, Reynoso JF, Tsang AW, Oleynikov D: Comparisons of outcomes of laparoscopic and open appendectomy in management of uncomplicated and complicated appendicitis. Ann Surg 2011 Dec, 254(6): 927-32
- Mason RJ, Moazzez A, Moroney JR, Katkhouda N: laparoscopic vs open appendectomy in obese patients: outcomes using the American College of Surgeons National Surgical Quality Improvement Program Database. J Am Coll Surg. 2012 Jul, 215(1): 88-99; discussion 99-100
- Sheraz R, Vishal VR, Alison Ho, Alan K, James K, Jessica E, Ian B: Laparoscopic versus open appendectomy in obese patients. Int. Journal of Surg. 9. 2011,451: 455
- Kehagias I, Karamanakos SN, Panagioto-poulos S, Panagopoulos K, Kalfarentzos F: Laparoscopic vs open appendectomy: Which way to go? World J Gastroenterol. 2008 Aug 21, 14(31): 4909-4914
- Semm K: Endoscopic Appendectomy. Endoscopy. 1983, 15: 59-64
- Kurtz RJ, Heimann TM: Comparison of open and laparoscopic treatment of acute appendicitis. Am J Surg. 2001, 182: 211-214
- Garbutt JM, Soper NJ, Shannon WD, Botero A, Littenberg B: Meta-analysis of randomized control trials comparing laparoscopic and open appendectomy. Surg LaparoscEndosc. 1999, 9: 17-26
- Ward NT, Ramamoorthy SL, Chang DC, Parsons JK: Laparoscopic appendectomy is safer than open appendectomy in elderly population. JSLS. 2014, 18(3).