A retrospective study on laparoscopic appendectomy versus open appendectomy

P. Senthil Kumar; S. Edwin Kin’s Raj; Saranya Nagalingam

doi:10.18203/2349-2902.isj20191127

Authors

P. Senthil Kumar Department of General Surgery, Kanyakumari Government Medical College, Kanyakumari, India
S. Edwin Kin’s Raj Department of General Surgery, Thoothukudi Medical College, Kamarajar Nagar, Thoothukudi, Tamil Nadu, India
Saranya Nagalingam Intensive Care Unit (ICU), Velammal Medical College, Hospital and Research Institute, Madurai, Tamil Nadu, India http://orcid.org/0000-0003-0826-2403

DOI:

https://doi.org/10.18203/2349-2902.isj20191127

Keywords:

Acute appendicitis, Open appendicectomy, Laparascopic appendicectomy, Gold standard, McBurney incision

Abstract

Background: Appendectomy is the most common surgical procedure performed in emergency surgery. Open appendectomy is the “gold standard” for the treatment of acute appendicitis. Laparoscopic appendectomy though widely practiced has not gained universal approval. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a retrospective study.

Methods: The study was done as a retrospective study among 387 patients diagnosed with appendicitis for a period of 18 months in the Dept of General Surgery. All patients included were 16 years and above and followed up for 3 weeks. In this study, 130 patients diagnosed as acute appendicitis - underwent open appendectomy and 257 patients diagnosed as sub-acute cases of appendicitis - underwent laparoscopic appendectomy. These two groups (open & laparoscopic) were compared for operative time, length of hospital stay, postoperative pain, complication rate, early return to normal activity.

Results: Laparoscopic appendectomy was associated with a shorter hospital stay (around 4.5 days), with a less need for analgesia and with an early return to daily activities (around 11.5 days). Operative time was significantly shorter in the open group (35 mins), when compared with laparoscopic group (around 59 mins). Total number of complications was less in the Laparoscopic group with a significantly lower incidence of post-op pain and complications.

Conclusions: The laparoscopic approach is a safe and efficient operative procedure and it provides clinically beneficial advantages over open appendectomy (including shorter hospital stay, an early return to daily activities and less post-op complications).

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Author Biography

Saranya Nagalingam, Intensive Care Unit (ICU), Velammal Medical College, Hospital and Research Institute, Madurai, Tamil Nadu, India

Intensive Care Unit

References

Petroianu A. Diagnosis of acute appendicitis. Int J Surg. 2012;10(3):115-9.

Sellars H, Boorman P. Acute appendicitis. Surgery. 2017;35(8):432–8.

Mcburney. The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg. 1894;20(1):38.

Semm K. Endoscopic appendectomy. Endoscopy. 1983;15(02):59-64.

Litynski GS. Kurt Semm and the fight against skepticism: endoscopic hemostasis, laparoscopic appendectomy, and Semm's impact on the “laparoscopic revolution”. J Society Laparoendoscopic Surg. 1998;2(3):309.

Paya K, Fakhari M, Rauhofer U, Felberbauer FX, Rebhandl W, Horcher E. Open versus laparoscopic appendectomy in children: a comparison of complications. J Society Laparoendoscopic Surg. 2000;4(2):121.

Sweeney KJ, Keane FB. Moving from open to laparoscopic appendicectomy. BJS. 2003;20:257-8.

Sauerland S, Lefering R, Holthausen U, Neugebauer EA. Laparoscopic vs conventional appendectomy--a meta-analysis of randomised controlled trials. Langenbecks Arch Surg. 1998;383(3-4):289-95.

Rbihat HS, Mestareehy KM, Al lababdeh MS, Jalabneh TM, Aljboor ME, Uraiqat AA. Laparoscopic versus open appendectomy retrospective study. Int J Adv Med. 2017;4(3):620-2.

Vellani Y, Bhatti S, Shamsi G, Parpio Y, Ali TS. Evaluation of laparoscopic appendectomy vs. open appendectomy: a retrospective study at Aga Khan University Hospital, Karachi, Pakistan. J Pak Med Assoc. 2009;59(9):605-8.

Kouhia ST, Heiskanen JT, Huttunen R. Long-term follow-up of a randomized clinical trial of open versus laparoscopic appendicectomy. Br J Surg. 2010;97(9):1395-400.

Golebiewski A, Losin M, Murawski M. One, two or three port appendectomy - a rational approach. Wideochir Inne Tech Malo Inwazyjne. 2013;8(3):226-31.

Karamanakos SN, Sdralis E, Panagiotopoulos S. Laparoscopy in the emergency setting: a retrospective review of 540 patients with acute abdominal pain. Surg Laparosc Endosc Percutan Tech. 2010;20(2):119-24.

Biondi A, Di Stefano C, 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.

Shaikh AR, Sangrasi AK, Shaikh GA. Clinical Outcomes of laparoscopic versus open Appen-dectomy. JSLS. 2009;13:574–80.

Agresta F, De Simone P, Leone L, Arezzo A, Biondi A, Bottero L, et al. Italian Society of Young Surgeons (SPIGC). Laparoscopic appendectomy in Italy: an appraisal of 26,863 cases. J Laparoendosc Adv Surg Tech A. 2004;14:1–8.

Adams HL, Jaunoo SS. A comparison of length of hospital stay between open appendicectomy and laparoscopic appendicectomy: a large retrospective study. Int Surg J. 2015;2(2):165-8.