Open Versus Laparoscopic Surgery for Acute Appendicitis: Clinical Comparative Outcomes at Single Academic Centre (VIMS-Kolkata)
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 2
Abstract
Introduction: Laparoscopic appendicectomy is emerging as a popular treatment modality for acute appendicitis but it is still far from attaining the status of “gold standard”. The aim of this study was to compare and evaluate the results of open and laparoscopic treatment for acute appendicitis in a prospective randomized unicentre study. Material and Methods: Sixtythree patients underwent for operative interventions after stratified random sampling; 30 patients underwent for laparoscopic appendicectomy (LA) and 33 patients underwent open appendicectomy (OA) with diagnosis of suspected acute appendicitis. The two groups were compared in terms of duration of surgery, length of hospital stay, intra-operative and post-operative complications. For statistical analysis; Chi-square (x2) and Mann-whitney U test were used. Result: As compared to open appendicectomy, laparoscopic appendicectomy was associated with shorter hospital stay (3vs5 days, p<0.05) with low incidence of wound infection (3%vs18%, p<0.05).The incidence of intra-abdominal abscess formation and adhesive ileus was more in LA group statistically insignificant. (p>0.05). The mean time for post-operative duration of i.v. fluid infusion [LA:8.63hrs, OA:22hrs, p<0.01] and requirement of analgesic either by parentral route[2 doses Vs 4 doses, p<0.01] or by oral route[LA:2 doses, OA:6 doses, p<0.01] and return to normal activity was less in LA group as compared to OA group. Conversion to open was necessary in two cases only and an incisional hernia case was also reported in follow up period. Conclusion: We conclude that routine laparoscopy and laparoscopic appendicectomy for suspected acute appendicitis is safe and clinically beneficial operative procedure and postoperative outcomes including hospital stay was significantly short. Laparoscopic appendicectomy was associated with fewer wound infection, faster recovery, earlier return to bowel sounds, normal activity with less pain and improved cosmesis.
Authors and Affiliations
Sanjeev Prakash, Manoj Kumar Shaw, Ashok Kumar Saraf, Amit Keshri
Keywords
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