ABSTRACT
Background: Appendicectomy is one of the most common surgical procedures performed in emergency surgery. Despite this, there is still lack of consensus about the most appropriate technique for appendicectomy. In this longitudinal analysis, we aimed to compare the outcomes of laparoscopic appendicectomy (LA) and the conventional technique or open appendicectomy (OA) in the treatment of acute appendicitis.Methods: A non-randomized longitudinal comparative study was conducted in NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India. From November 2017 to October 2019, 53 patients underwent OA and 59 underwent LA, making a total number of patients included in this study to be 112 (n). The two groups were compared for operative time, length of hospital stay, postoperative pain, post-operative ileus and complication rate.Results: Laparoscopic appendicectomy was associated with a shorter hospital stay (4.34±1.37 days in LA and 5.09±1.71 days in OA, p<0.01), with a lower post operative pain score [VAS] (2.93±0.80 in LA and 4.62±0.92 in OA, p<0.001). Operative time was shorter in the open group (42.70±12.05 min in OA and 43.39±16.59 in LA). Complications were lesser in the LA group with a significantly lower incidence of wound infection (3.4% in LA and 13.2% in OA).Conclusions: Laparoscopic approach is safe and efficient in appendicectomy and it provides clinically advantages over open method (shorter hospital stays, lower post op pain, early food tolerance, earlier return to work and lesser wound infection) against only marginally longer operative time.
ABSTRACT
Background: Open appendectomy has been the gold standard for the treatment of acute appendicitis since its introduction by Charles Mc Burney in 1889.The introduction of laparoscopic surgery has dramatically changed the field of surgery. Various studies showed conflicting results about the superiority of laparoscopic approach over open for treatment of acute appendicitis. Present study is conducted to determine any possible benefits of the laparoscopic approach over open surgery.Methods: The study was conducted in Dr. V. M. Government Medical College and hospital located in Solapur (Maharashtra) from September 2017 to September 2019. It is a prospective comparative study. Patients were randomly divided into 2 groups alternately where group A and B were operated by conventional and laparoscopic techniques respectively and their outcomes were compared.Results: Mean age of patients in open and laparoscopic appendicectomy group was 29.67 years and 31 years respectively. Post-operative pain, wound infection and hospital stay was significantly more in open group as compared to laparoscopic group (p<0.05).Conclusions: From the results of our study we conclude that laparoscopic appendicectomy has superior results as compared to open appendicectomy.
ABSTRACT
Introduction: Appendicitis is the most common causeof surgical abdomen in all age groups with a lifetime riskof 6%. The role of laparoscopic appendicectomy remainscontroversial as many researchers have suggested thatoverall morbidity is primarily a function of the degree of theappendicitis rather than the operative approach. The presentstudy was designed to compare the outcome of laparoscopicappendicectomy versus open appendicectomy in a tertiarycare hospital.Material and methods: This was a randomized controlledstudy on 100 cases of acute appendicitis operated inRohilkhand Medical College, Bareilly in a period of one year.The patients were randomly assigned to two groups of 50 eachoperated by open and three port laparoscopic surgery.Results: Abdominal pain (100%) was the commonestpresenting complaint. Retrocaecal anatomical position (76%in open, 70% in lap. appendicectomy) of the appendix wasthe commonest operative finding. Wound infection rate (8%)was insignificantly higher in open appendicectomy. Therewas significantly less operative time, postoperative painbetter cosmesis and early return to normal daily activity inlaparoscopic as compared to open appendicectomy.Conclusion: Laparoscopic appendicectomy is better ascompared to open appendicectomy in terms of post-operativecomplications, post-operative pain, hospital stay, early returnto normal activity, and subjective cosmesis.
ABSTRACT
Background: Vermiform appendix, though a vestigial organ in a human without much purpose forms. The most common cause of acute abdomen and also the most common surgical intervention by a general surgeon. Open appendicectomy has been practiced for more than 130 years all over the world with a good outcome. But laparoscopic appendicectomy grabbed the attention of not only surgeons but also the patients after the pioneering efforts of Kurt Semm in 1982. Although our hospital has been practicing open appendicectomy for many decades laparoscopic appendicectomy was introduced in recent past. The aim of the study: Aim was to compare the laparoscopic against open appendicectomy based on the following parameters: Post-surgical pain, Return of bowel sounds, Return to eating, Post-operative complications, Post-operative antibiotics duration. Materials and methods: Patients who come to the outpatient and emergency clinic of the Department of General Surgery, KAPV Government Medical College between January 2016 and June 2017. Among the patients who had come to General Surgery OP clinic and emergency clinic, after thorough examination patients with features of appendicitis were included as subjects for study. Patients were allotted as subjects in each group by simple random sampling. Blood investigation, Chest X-ray, X-ray abdomen, USG abdomen, CT abdomen were done and assessment obtained for Yeganathan Rajappan, Anandan Kanthan, Mahalakshmi Ashok Kumar, Manimaran Thangavelu. A comparative study between laparoscopic and open appendicectomy in KAPV Government Medical College, Trichy. IAIM, 2019; 6(3): 259- 265. Page 260 those patients after sufficient resuscitation with iv fluids, antibiotics, and analgesics. Patients who were diagnosed with appendicitis were explained about the diagnosis, need for surgery, surgical procedure planned and its complications and then informed written consent obtained. Results: In our study, mean operation duration for LA was 61.54 min and 51.62 min for open appendicectomy. The p-value was 0.022 which was significant statistically. Operation duration was short in laparoscopic appendicectomy. Our study also shows less pain for lap group which was calculated using a pain rating scale, with mean in OA as 3.16 and 2.32 in LA group and the p-value was p-0.000 which was statistically significant. Diet was started earlier in lap appendicectomy group in our study. Postoperative complication and postoperative antibiotics duration were less in LA group as like in earlier studies. Conclusion: Laparoscopic appendicectomy is better than open appendectomy in selected patients with acute or recurrent appendicitis.
ABSTRACT
Background: Appendicitis is sufficiently common that appendicectomy is the most frequently performed urgent abdominal surgery. Despite extraordinary advances in modern radiographic imaging and diagnostic laboratory investigations, the diagnosis of appendicitis remains essentially a clinical diagnosis. Aim of the study: To determine the outcome of laparoscopic appendicectomy compared to open appendectomy and to rule out the clinical outcome between two major procedures. Materials and methods: This comparative study was done in Government Medical College, Omandurar Government Estate in 2016 to 2018. A total of 75 patients' files that underwent surgery within the study period were perused. Thirty-two patients (42.7%) underwent laparoscopic surgery (LA) and 43 patients (57.3%) underwent open appendicectomy (OA). The relevant data was then extracted from the case notes using a pre-designed proforma questionnaire. Results: There were a total of 44 male patients and 31 female patients in the study. All patients undergoing either LA or OA presented with right iliac fossa pain. Patients who presented with nausea undergoing LA were 53.13% while 31.11% undergoing OA presented with nausea. Vomiting was present in 18.75% of patients undergoing LA while 44.44% of the patients undergoing OA had vomiting. Fever was noted in patients undergoing OA (15.55%). Majority of patients had symptoms duration of between one day and one week. Those with symptoms durations of less than one day were 9.4% for LA group and 23.3% for the OA group. Urea and electrolytes were done in 93.8% of A. Sagaya Inba Sekar, Anandi Andappan. Comparative study on laparoscopic appendicectomy versus open appendicectomy in a tertiary hospital at Chennai. IAIM, 2019; 6(3): 182-187. Page 183 patients undergoing LA and 69.8% of those undergoing OA. Abdominal ultrasound was performed in 40.6% of patients undergoing LA and 18.6% of a patient undergoing OA. Urinalysis and microscopy were performed in 6.3% of patients undergoing LA and 9.5% of patients undergoing OA. Wound sepsis occurred in 6.7% of patients undergoing OA. Miscarriage occurred in 1 patient undergoing OA. Only one patient in LA developed complication due to ileus. Conclusion: Laparoscopic appendicectomy takes longer to perform our institution than open appendicectomy. Postoperative complications are lower with laparoscopic appendicectomy when compared with open appendicectomy.
ABSTRACT
Currently, laparoscopic appendectomy is widely practiced for the management of acute appendicitis. It is not clear whether open or laparoscopic appendectomy is more appropriate. Our aim was to compare the safety and the advantages of laparoscopic versus open appendectomy in a prospective study. 102 patients were participated in this study. The group 1 patients were subjected to laparoscopic appendectomy [LA], whereas the group 2 patients were subjected to open appendectomy [OA]. 46 patients included in LA group and 54 patients in OA group. The mean operative time for LA and OA was 84.4 (45-220) minutes and 59 (30-180) minutes respectively. Although LA was associated with a shorter hospital stay [LA-3.5 days versus OA-5 days] but duration of operation is prolong in LA than OA and the postoperative wound infection is significantly higher in OA than LA. LA is safe and superior to OA in respect to an early discharge, lesser postoperative pain; decreased post operative wound infection, early return to work and a better cosmetic scar.