Comparative study on laparoscopic appendicectomy versus open appendicectomy in a tertiary hospital at Chennai
Journal Title: International Archives of Integrated Medicine - Year 2019, Vol 6, Issue 3
Abstract
Background: Appendicitis is sufficiently common that appendicectomy is the most frequently performed urgent abdominal surgery. Despite extraordinary advances in modern radiographic imaging and diagnostic laboratory investigations, the diagnosis of appendicitis remains essentially a clinical diagnosis. Aim of the study: To determine the outcome of laparoscopic appendicectomy compared to open appendectomy and to rule out the clinical outcome between two major procedures. Materials and methods: This comparative study was done in Government Medical College, Omandurar Government Estate in 2016 to 2018. A total of 75 patients' files that underwent surgery within the study period were perused. Thirty-two patients (42.7%) underwent laparoscopic surgery (LA) and 43 patients (57.3%) underwent open appendicectomy (OA). The relevant data was then extracted from the case notes using a pre-designed proforma questionnaire. Results: There were a total of 44 male patients and 31 female patients in the study. All patients undergoing either LA or OA presented with right iliac fossa pain. Patients who presented with nausea undergoing LA were 53.13% while 31.11% undergoing OA presented with nausea. Vomiting was present in 18.75% of patients undergoing LA while 44.44% of the patients undergoing OA had vomiting. Fever was noted in patients undergoing OA (15.55%). Majority of patients had symptoms duration of between one day and one week. Those with symptoms durations of less than one day were 9.4% for LA group and 23.3% for the OA group. Urea and electrolytes were done in 93.8% of patients undergoing LA and 69.8% of those undergoing OA. Abdominal ultrasound was performed in 40.6% of patients undergoing LA and 18.6% of a patient undergoing OA. Urinalysis and microscopy were performed in 6.3% of patients undergoing LA and 9.5% of patients undergoing OA. Wound sepsis occurred in 6.7% of patients undergoing OA. Miscarriage occurred in 1 patient undergoing OA. Only one patient in LA developed complication due to ileus. Conclusion: Laparoscopic appendicectomy takes longer to perform our institution than open appendicectomy. Postoperative complications are lower with laparoscopic appendicectomy when compared with open appendicectomy.
Authors and Affiliations
A. Sagaya Inba Sekar, Anandi Andappan
Keywords
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