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 intra-operatively 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.