To Review The Outcome Of Laparoscopic Appendicectomy Versus Open Appendicectomy

ABSTRACT

Proponents of laparoscopic appendectomy emphasize the advantages of laparoscopic operation decreased hospitalization, less operating time and minimal complication. this study includes comparison between laparoscopic vs open appendectomy. 50 patients in each group were included in the study during the period of November 2015 to June 2017.There were 60 male patients while female patients were 40. Of the 60 male patients, 34 patients underwent LA while 26 patients underwent OA. 16 female patients underwent LA, while 24 female patients underwent OA. All patients presented with complaint pain. Nausea was present in 54% of the patients and vomiting in 81%. Fever was present in 58%. Per-operative diagnosis were slightly different than USG findings . 19% patients had enlarged appendix with dilated bowel loop, 4% patients had adhesions of bowel, 61% patients had acute appendicitis with omental adhesion, 8 % patients had RIF collection, 2% patients had only inflamed appendix, 3%patients had gangrenous perforated appendix with flakes, 3% patients had enlarged dilated appendix with dilated bowel loop. In our study most common anatomical position was retrocaecal 72%, 24% had pelvic postion,1% had preileal and 3% had subcaecalposition. Operating time was longer in the OA group compared to LA group and was statistically significant. The median operation time for the LA was 20-30 minutes while that of OA was 40-50 minutes. Patients who underwent LA had a shorter hospital stay compared to OA group. The average duration of hospital stay for LA group in the study was 3-4 days while for the OA group was 5-6 days. In the LA group, only 1 patient (2%) developed caecal perforation, while 3 (6%) patients developed port site infections . For those undergoing OA, 16% had complications. The most common being wound sepsis, which occurred, in 14% of the patients. One patient had developed small bowel obstruction which was diagnosed 7 days after the surgery.