Laparoscopic versus open appendectomy in patients with acuteappendicitis

Abstract

Background: Laparoscopic surgery for
appendicitis is now a well established and
advanced method of performing general surgical
procedures.
Objectives: To compare the outcome of
laparoscopic and open appendectomies in terms
of operative time, analgesic requirement,
postoperative complications, hospital stay, return
to normal activity and condition of scar.
Methods: This prospective study was carried
out from 1stMay 2008-1st January 2010, involving
110 patients (45 male and 65 female) with
features suggestive of acute appendicitis were
divided into 45 patients laparoscopic
appendectomy (LA) group and 65 patients open
appendectomy (OA) group, after taking informed
consent. LA was done with the help of three
trocars/cannulae creating pneumoperitoneum
with CO2 whereas OA was performed by grid
iron incision.
Results: Forty five patients were assigned to
the laparoscopic appendectomy group and 65
patients were assigned to the open appendectomy
group. Five patients were converted intraoperatively
from laparoscopic appendectomies to
open procedures. The operating times in OA and
LA were 20-110 minutes (mean 30) and 45-120
minutes (mean 55) respectively. Increased doses
of analgesics, antibiotics and antiemetics were
required in OA, as compared to LA. The mean
postoperative hospital stay in LA group was 1
day (range 1-3 days) where as it was; 2.2 days
(range 2-5 days) in OA group.
Conclusion: LA is safe and it has major
benefits like less postoperative pain, decreased
wound infection, early hospital discharge, early
return to work and a better cosmetic scar than
OA