Comparative evaluation of laparoscopic versus open appendicectomy in cases of acute appendicitis
DOI:
https://doi.org/10.18203/2349-2902.isj20173403Keywords:
Appendicitis, Laparoscopic appendicectomy, Open appendicectomyAbstract
Background: Conventional open appendicectomy is a common emergency surgical procedure being used for more than a century. Despite continuously increasing popularity of minimal access surgery, laparoscopic appendicectomy has not gained enough popularity.
Methods: A prospective randomized study to compare laparoscopic and open appendicectomy for the treatment of appendicitis was carried out from April 2015 to October 2016. Thirty patients each were randomized to two groups. Decision to operate was taken on clinical grounds.
Results: Twenty-five patients in each group were confirmed to be suffering from appendicitis. While alternative diagnosis could be established in 4 out of remaining 5 patients in laparoscopic group, in only 1 out of 5 patients from open appendicectomy definitive diagnosis for pain could be established. There was no significant difference in operative time between two groups. Patients in laparoscopic group had lesser postoperative pain scores and wound complications. They also got discharged and returned to normal activity earlier than those in open appendicectomy group.
Conclusions: Laparoscopic appendicectomy has lesser postoperative morbidity and improves diagnosis in nonappendicitis patients.
References
McBurney C. The incision made in the abdominal wall in cases of appendictis, with a description of a new method of operating. Ann Surg. 1994;20:38-43.
Semm K. Endoscopic appendectomy. Endoscop. 1983;15:59-64.
Pier A, Gotz F, Bacher C. Laparoscopic appendectomy in 625 cases: from innovation to routine. Surg Laparosc Endosc. 1991;1:8-13.
Khalil J, Muqim R, Rafique M, Khan M. Laparoscopic versus open appendectomy: A comparison of primary outcome measures. Saudi J Gastroenterol. 2011;17:236-40.
Ortega AE, Hunter JG, Peters JH, Swanstrom LL, Schirmer B. Laparoscopic appendectomy study group. A prospective, randomized comparison of laparoscopic appendectomy with open appendectomy. Am J Surg. 1995;169(2):208-13.
Ohmann C, Yang Q, Franke C. Diagnostic scores for acute appendicitis. Abdominal pain study group. Eur J Surg. 1995;161:273-81.
Macklin CP, Radcliffe GS, Mere JM, Stringer MD. A prospective evaluation of the modified Alvarado score for acute appendicitis in children. Ann R Coll Surg Engl. 1997;79:203-5.
Kanumba ES, Mabula JB, Rambau P, Chalya PL. Modified alvarado scoring system as a diagnostic tool for acute appendicitis at Bugando Medical Centre, Mwanza, Tanzania. BMC Surg. 2011;11:4.
Van Randen A, Bipat S, Zwinderman AH, Ubbink DT, Stoker J, Boermeester MA. Acute appendicitis: meta-analysis of diagnostic performance of CT and graded compression US related to prevalence of disease. Radiol. 2008;249:97-106.
Laine S, Rantala A, Gullichsen R, Ovaska J. Laparoscopic appendectomy: is it worthwhile? A prospective, randomized study in young women. Surg Endosc. 1997;11:95-7.
Minutolo V, Licciardello M, Stefano BD, Arena M, Arena G, Antonacci V. Outcomes and cost analysis of laparoscopic versus open appendectomy for treatment of acute appendicitis: 4-years’ experience in a district hospital. BMC Surg. 2014;14:14.
Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R. Laparoscopic versus open appendectomy a prospective randomized double-blind study. Ann Surg. 2005;242:439-50.
Shaikh AR, Sangrasi AK, Shaikh GA. Clinical outcomes of laparoscopic versus open appendectomy. JSLS. 2009;13:574-80.
Li X, Zhang J, Sang L, Zhang W, Chu Z, Li X, et al. Laparoscopic versus conventional appendectomy- a meta-analysis of randomized controlled trials. BMC Gastroenterol. 2010;10:129.
Islam SR, Pasha K, Rahman S, Nasir E, Hanif E, Barman A. Laparoscopic vs open appendectomy: a comparative study. Bangladesh J Endosurg. 2014;2(1):5-8.
Biondi A, Stefano CD, Ferrara F, Bellia A, Vacante M, Piazza L. Laparoscopic versus open appendectomy: a retrospective cohort study assessing outcomes and cost-effectiveness. World J Emerg Surg. 2016;11:44.
Guller U, Hervey S, Purves H, Muhlbaier LH, Peterson ED, Eubanks S, et al. Laparoscopic versus open appendectomy outcomes comparison based on a large administrative database. Ann Surg. 2004;239(1):43-52.
Karatparambil A, Kummankandath SA, Mannarakkal R, Nalakath MR, Babu D. Laparoscopic versus open appendicectomy: a comparative study. Int Surg J. 2016;3(1):128-34.
Katkhouda N, Mason RJ, Towfigh S, Gevorgyan A, Essani R. Laparoscopic versus open appendectomy a prospective randomized double-blind study. Ann Surg. 2005;242:439-50.
Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev. 2004;18:CD001546.
Khan MN, Fayyad T, Cecil TD, Moran BJ. Laparoscopic versus open appendectomy: the risk of postoperative infectious complications. JSLS. 2007;11:363-7.
Merhoff AM, Merhoff GC, Franklin ME. Laparoscopic versus open appendectomy. Am J Surg. 2000;179:375-8.
Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a meta-analysis. J Am Coll Surg. 1998;186:545-53.
Klingler A, Henle KP, Beller S. Laparoscopic appendectomy does not change the incidence of postoperative infectious complications. Am J Surg. 1998;175:232-5.
Temple LK, Litwin DE, Mcleod RS. A metaanalysis of laparoscopic versus open appendectomy in patients suspected of having acute appendicitis. Can J Surg. 1999;42:377-83.
