A Comparative Study of Laparoscopic Versus Open Appendectomy


ABSTRACT:BACKGROUND:Laparoscopic appendectomy has gained popularity in recent years and has become one of the most widely performed procedures. However, it is not the universal gold standard as laparoscopic cholecystectomy for acute cholecystitis. This is, perhaps, due to the emergency nature of disease often operated by junior staff in odd hours when laparoscopic equipment, trained staff and supervision may not be availableOBJECTIVE:To compare the results of open with laparoscopic appendectomy in terms of postoperative pain, rate of wound infection and hospital stay.PATIENTS & METHODS:This study was conducted in Al- Kadhmyia teaching hospital, over a period of six months from the 1st of October 2009 to the 1st of April 2010. Patients undergoing surgery for acute appendicitis were randomly assigned into one of the two groups (A or B) after obtaining written and informed consent. In Group-A patients underwent open appendectomy and in Group B laparoscopic appendectomy was performed. Post operatively pain chart, days of hospital stay and wound infection was recorded.RESULT:Sixty patients (38 male, 22 female), with clinical diagnosis of acute appendicitis based on Alvarado score of six and above, were included in the study. They were randomized into 2 groups of A and B with 30 patients in each group. Group-A comprised open appendectomy procedure and Group-B comprised laparoscopic appendectomy. Comparison of postoperative pain by visual analogue scale was significantly low in Group B, compared with Group A, on day 0, 1 and 2. Number of days in Hospital was 4.1±0.8 days in Group A and 1.5±0.06 days in Group B. None of the patients in Group B, while 8 (26.67%) patients in-Group A, developed postoperative wound infection at 1 week follow up.CONCLUSION:Laparoscopic appendectomy is safe and effective. Postoperative pain, hospital stay and wound infection were significantly lower after this mode of surgery