Scar pain, cosmesis and patient satisfaction in laparoscopic and open cholecystectomy

Objective: To compare patient-satisfaction, scar-pain and cosmesis between laparoscopic and open-cholecystectomy. Study Design: Cross-sectional survey. Place and Duration of Study: Khyber Teaching Hospital, Peshawar, from August 2012 to May 2014

Methodology: A total of 400 patients, who had undergone open or laparoscopic cholecystectomy in all units of the Surgical Department, were included. Data was collected on questionnaires given and read to the patients along with counselling and information regarding scar-pain using visual analog score, and satisfaction and cosmesis on a 0 - 10 scale, by a medical professional in the patients' native language. This was done postoperatively on patients' follow-up visits at 1 and 4 weeks

Results: Mean scar pain score at 1 and 4 weeks postoperatively was higher for open-cholecystectomy; 4.96 +/- 1 and 0.96 +/- 1, compared to 2.24 +/- 0.6 and 0, respectively for laparoscopic-cholecystectomy [p < 0.001 and < 0.001]. Cosmesis was higher for laparoscopic-group; 8.6 +/- 1.2 vs. 6.2 +/- 1.46 for open-cholecystectomy [p < 0.001]. Patient-satisfaction was higher for laparoscopic-cholecystectomy; 9.28 +/- 1.5 vs. 8.32 +/- 2.3 for open-cholecystectomy [p < 0.001]. Mean-cosmesis score was higher for laparoscopic-cholecystectomy for those younger than 40, females and unmarried. Mean patientsatisfaction score was higher for those older than 40 years who had undergone open-cholecystectomy, women who had undergone laparoscopic-cholecystectomy and for unmarried patients who had laparoscopic-cholecystectomy

Conclusion: Overall patient-satisfaction and cosmesis scoring was higher for laparoscopic-cholecystectomy especially among females, unmarried and younger than 40 years. Patients of 40 years and older had greater satisfaction scoring for open-cholecystectomy. Therefore, laparoscopic-cholecystectomy should be favoured in females and unmarried patients and those younger than 40 years

Receiver operator characteristic curve analysis of the Lintula score for reduction of negative appendectomies in adults

To evaluate the Lintula score in reducing negative appendectomies in the adult population. Descriptive analytical study. Surgical Department, Khyber Teaching Hospital, Peshawar, Pakistan, from August 2012 to April 2014. A total of 408 emergency patients with a clinical diagnosis of acute appendicitis were included in the study. True or negative appendectomy status was determined per-operatively. Lintula score was calculated afterwards and evaluated for various cut-off points. Among the study population, 72 [17.6%] had a normal appendix by operative assessment and 336 [82.4%] had an acutely inflammed appendix. The receiver operating characteristic curve showed that the optimal cut-off point was