ABSTRACT
Background: Acute appendicitis is the most frequent condition leading to emergency abdominal surgery. Open appendectomy [OA] has been the gold standard for the treatment for acute appendicitis for more than a century. Although it is safe, the incidence of post operative complications is 10% to 20%, with 0.3% overall mortality. Patients undergoing laparoscopic Appendectomy [LA] have less postoperative pain, less impairment of vital functions, and they resume usual activities more rapidly
Objective: To compare the outcomes of laparoscopic and open appendectomy in the treatment of acute appendicitis with regard to hospital stay, length of operation, return to normal activity and post operative pain
Patients and Methods: This experimental study was conducted at Department of Surgery, Bahawal Victoria Hospital from 1[st] November, 2011 to 30[th] June, 2012. A total of 112 patients with similar characteristics of appendicitis were selected. Patients of acute appendicitis were divided into two groups A and B comprising of 56 patients each. Open appendectomy was performed in group A and laparoscopic in group B. Sampling technique was purposive non probability sampling. Demographics, length of operation, post operative pain, hospital stay and return to normal activity were documented. Statistical Analysis was done with SPSS v 13
Results: A total of 56 patients were allocated to LA group while another 56 patients to OA group. There were no significant difference between the two groups with respect to mean age. Mean operative time was longer in LA than in OA group [P value: 0.028]. Post operative pain was less in LA group, resulting in less use of analgesics; Hospital stay was shorter in LA group [p value <0.001]. Return to normal activity was earlier in LA group [p value: 0.008]
Conclusion: Laproscopic appendectomy has advantage over open appendectomy, in terms of its ability of lower post operative pain and reduced hospital stay. It is concluded that in clinical settings where laparoscopic surgical expertise and equipment are available and affordable, LA seems to be an effective and safe alternative to OA