A prospective study to compare laparoscopic appendicectomy versus open appendicectomy in acute appendicitis

Abstract

Background: Acute appendicitis is among the commonest surgical emergencies, and while laparoscopic appendicectomy (LA) has gained favour for its reported postoperative benefits, open appendicectomy (OA) remains widely practised, particularly in resource-constrained teaching hospitals. Comparative outcome data from such settings remain limited.

Methods: This prospective comparative study was conducted at a tertiary care teaching hospital over 18-24 months in 167 patients with confirmed acute appendicitis, of whom 44 underwent LA and 123 underwent OA based on clinical presentation and surgeon judgement. Operative duration, postoperative pain, time to oral intake, hospital stay, complications, recovery status, cosmetic outcome and sequelae were recorded and compared descriptively.

Results: Both groups were predominantly young adults. The LA group had a more balanced sex distribution than the OA group, which showed male predominance. Operative duration was similar between groups. LA patients resumed oral intake earlier and were discharged sooner than OA patients, and reported better cosmetic outcomes. Complication and recovery profiles were broadly comparable between the two groups; with scar pain the only sequela recorded at follow-up.

Conclusions: Both LA and OA were associated with acceptable postoperative outcomes in this cohort. LA was associated with earlier oral intake, shorter hospital stays and better cosmesis, while operative duration and recorded complication rates were broadly comparable between the two techniques.