Outcome comparison study between laparoscopic appendisectomy and conventional open appendisectomy

Authors

  • Mimamaychet B. Sangma Department of General Surgery, Indira Gandhi Medical College and Research Institute, Puducherry, India
  • Selvakumaran Selvaraju Department of General Surgery, Indira Gandhi Medical College and Research Institute, Puducherry, India
  • Pratheeba Natarajan Department of Anaesthesiology, Indira Gandhi Medical College and Research Institute, Puducherry, India
  • Fremingston Marak Department of Forensic Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, India
  • Simon David Dasiah Department of General Surgery, Indira Gandhi Medical College and Research Institute, Puducherry, India

DOI:

https://doi.org/10.18203/2349-2902.isj20191471

Keywords:

Open appendisectomy, Laprascopic appendisectomy, Acute appendicitis

Abstract

Background: Open appendisectomy (OA) had been the procedure of choice for acute appendisectomy for a century since Mc Burney introduced in 1884. Laprascopic appendisectomy (LA) didn’t gain popularity and many studies had been conducted to see the superiority of one over the other. Recent meta-analysis studies, found overall benefits in favour of LA. So, we have done comparative study with the aim to compare the benefits of LA over OA.

Methods: Total of 90 appendisectomies was done, 45 each in OA and LA group and compared over a period of 1-year from October 2016 to October 2017 in Indira Gandhi Medical College and RI, Pondicherry. Outcome parameters were compared between the 2-groups in relation to operative time, analgesia used, length of post-operative hospital stay, return to work, resumption of a regular diet, post-operative scar and post-operative complications.

Results: Mean age of LA was 35 years, OA was 30 years. Male preponderance observed in OA (67%), female in LA (60%). Post-operative short hospital stay was 3-days in LA, 5-days in OA. Early return to work was 9-days in LA, 15-days in OA. Operative time was significantly shorter in LA which was 30-minutes and 40-minutes in OA. In laprascopic group, no complications was observed, in open group we had two post-operative infections.

Conclusions: LA is an effective and safe option and the procedure of choice for most patients regardless of age, sex and BMI, with a statistically significant finding in regards to operation time in LA compared to conventional OA group.

Author Biographies

Mimamaychet B. Sangma, Department of General Surgery, Indira Gandhi Medical College and Research Institute, Puducherry, India

Associate Professor and Head of Unit-II, Department of General Surgery,

Selvakumaran Selvaraju, Department of General Surgery, Indira Gandhi Medical College and Research Institute, Puducherry, India

Assistant Professor, Department of General Surgery

Pratheeba Natarajan, Department of Anaesthesiology, Indira Gandhi Medical College and Research Institute, Puducherry, India

Associate Professor, Department of Anaesthesiology

Fremingston Marak, Department of Forensic Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, India

Associate Professor and Head, Department of Forensic Medicine

Simon David Dasiah, Department of General Surgery, Indira Gandhi Medical College and Research Institute, Puducherry, India

Profesor and Head, Department of General Surgery

References

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;239:43–52.

Kumar B, Samad A, Khanzada TW, Laghari MH, Sheikh AR. Superiority of laproscopic appendicectomy over open appendicectomy. Rawal Med J. 2008;33:165-8.

Mc Burney C. The incision made in the abdominal wall in case of appendicitis with a description of a new method of operating. Ann Surg. 1894;20(1):38–43.

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

Chung RS, Rowland DY, Li P, Diaz J. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg. 1999;177:250-6.

Garbutt JM, Soper NJ, Shannon WD, Botero A, Littenberg B. Meta-analysis of randomized controlled trials comparing laparoscopic andopen appendectomy. Surg Laparosc Endosc. 1999;9:17-26.

Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: a meta-analysis. J Am Coll Surg. 1998;186:545-53.

Sauerland S, Lefering R, Holthausen, Neugebauer EAM. Laparoscopic versus conventional appendectomy–a meta-analysis of randomized controlled trials. Langenbecks Arch Surg. 1998;383:289-95.

Shaikh AR, Sangrasi AK, Shaikh GA. Clinical Outcomes of Laparoscopic Versus Open Appendectomy. JSLS. 2009;13:574–80.

Islam SR, Pasha K, Pasha K, Rahman S, Nasir E. Hanif E, et al. Laprascopic VS Open Appendisectomy: A Comparative Study. Bangladesh J Endosurg. 2014;2:1-4.

Attwood SE, Hill AD, Murphy PG, Thornton J, Stephens RB. A prospective randomized trial of laparoscopic versus open appendectomy. Surgery. 1992;112:497-501.

Thakre S, Mujalde VS, Mudgal MM, Kushwah N, Gupta A. A Comparative Study between Laparoscopic Appendectomy and Conventional Open Appendectomy. Sch. J. App. Med. Sci. 2014; 2(5F):1909-12

Lin HF, WuJm, Tseng LM, Chen KH, Huang SH, Lai IR. Laparoscopic vs open appendisectomy for perforated appendicitis. J Gastro Surg. 2006;10(6):906-10.

Pederson AG, Peterson OB, Wara P, Rowning H, Qvist N, Laurberg S. Randomised clinical trial of laparoscopic versus open appendicectomy. Br J Surg. 2001;88:200-5.

Azaro EM, Amaral PCG, Ettinger JETM, Souza ELQ, Fortes MF, Alcantara RSM, et al. Laparoscopic versus Open appendicectomy: a comparative study. J Soc Lap Surg. 1999;3:279-83.

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Published

2019-04-29

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Original Research Articles