Randomized, Single-blinded Trial of Laparoscopic Versus Open Appendectomy in Children

1996 ◽  
Vol 84 (4) ◽  
pp. 801-806. ◽  
Author(s):  
C. Lejus ◽  
L. Delile ◽  
V. Plattner ◽  
M. Baron ◽  
S. Guillou ◽  
...  
Keyword(s):  
Operative Time ◽  
Demographic Data ◽  
Open Appendectomy ◽  
Group Versus ◽  
Laparoscopic Group ◽  
Postoperative Recovery ◽  
Open Group ◽  
Laparoscopic Versus Open Appendectomy ◽  
Blinded Trial

Background The benefit of laparoscopy to patients has been clearly established in adults undergoing cholecystectomy. Results are less clear for appendectomy. The current study was undertaken to compare the respective 3-day postoperative periods after laparoscopic and open appendectomy in children. Methods Sixty-three children (aged 8-15 yr) scheduled for appendectomy were randomly assigned to two groups: open and laparoscopic. Postoperative evaluation included delay of postoperative recovery (walking and feeding), pain assessment by visual analog scale during the 3 subsequent days, amount of nalbuphine administered via a patient-controlled analgesia system during the first 48 h and responses by children, parents, and nurses on the overall quality of analgesia. Results There was no difference between groups for demographic data (particularly macroscopic aspect of appendix) analgesia, sedation, delay before eating and walking, incidence of urinary retention, nausea, vomiting. Operative time was long (P < or = to 0.05) in the laparoscopic group (54 +/- 17 min) than in the open group (39 +/- 18 min). Thirty five percent of the children had pain at the shoulder in the LAP group versus ten percent in the open group (P < or = 0.05). Conclusions Laparoscopy did not improve analgesia and postoperative recovery after appendectomy in children.

scholarly journals Clinical outcome of appendectomy: laparoscopic vs open technique

2021 ◽  
Vol 9 (1) ◽  
pp. 93
Author(s):  
Jan M. Rather ◽  
Sobia Manzoor ◽  
Mubashir Shah
Keyword(s):  
Clinical Outcome ◽  
Acute Appendicitis ◽  
Standard Care ◽  
Operative Time ◽  
Open Appendectomy ◽  
Laparoscopic Group ◽  
Open Group ◽  
Complication Rates ◽  
Open Technique ◽  
Duration Of Hospital Stay

Background: Acute appendicitis is a common abdominal surgical emergency. Appendectomy has been proven to be the standard care for the treatment of acute appendicitis. Objective of the study was to compare laparoscopic and open appendectomy in terms of clinical outcome and complication rates.Methods: This was a single centric, retrospective study conducted at SKIMS, Soura from May 2018 to April 2021. Open and laparoscopic appendectomy patients were compared in terms of operative times, conversion rate, complication rates and duration of hospital stay.Results: Total 120 patients were included in this study with 40 in laparoscopic group while 80 patients in the open group. Increased operative time in laparoscopic group (p=0.033) and longer duration of hospital stay (p=0.021) with open group while as comparable complication rate in both procedures were observed. Higher rates of intra-abdominal collection in laparoscopic group as compared to open groupConclusions: Both laparoscopic and open appendectomy procedures can be performed routinely for acute appendicitis without the additional risks of complications.

scholarly journals Complications after Laparoscopic Appendectomy for Complicated Appendicitis

2020 ◽  
Vol 19 (1-2) ◽  
pp. 34-41
Author(s):  
Andrej Nikolovski ◽  
Shenol Tahir ◽  
Dragoslav Mladenovikj
Keyword(s):  
Postoperative Complications ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Open Appendectomy ◽  
Laparoscopic Group ◽  
Complicated Appendicitis ◽  
Open Group ◽  
Uncomplicated Appendicitis ◽  
Low Incidence

Background. Laparoscopic appendectomy is established method in the treatment of complicated appendicitis. Certain advantages of the technique do not fulfill the expectations for its superiority over the open appendectomy as when it is used for uncomplicated appendicitis. This is generally caused because of the high variety of postoperative complications reported in different series for complicated appendicitis. Material and methods. This prospective interventional clinical study analyzes 61 patients operated with laparoscopic and open appendectomy due to complicated appendicitis, with an end point of comparing the intra and postoperative complications in both groups. Results. Conversion in open appendectomy was forced in one patient (1.63%). The operative time was significantly shorter in the laparoscopic group (p = 0.048). Wound infection was significantly predominant in the open group (p = 0.045). Postoperative intraabdominal abscess occurred in one patient in the laparoscopic group (p = 0.52). The overall morbidity was 26.2% (7 patients in the laparoscopic, and 9 in the open group; p = 0.59). Length of stay was significantly shorter in the laparoscopic group (p = 0.00001). Conclusion. Certain significant advantages of the laparoscopic appendectomy as low incidence of wound infection, short hospitalization, less postoperative pain and faster socialization makes the laparoscopy up to date method in the treatment of complicated appendicitis.

scholarly journals Outcome of Hemorrhoidectomy with the Ligasure in Comparison with the Traditional open Method

2017 ◽  
Vol 4 (1) ◽  
pp. 4-7
Author(s):  
Fiaz -Ur- Rahman ◽  
Arshad Amin ◽  
Shahid Nisar ◽  
Musarat Hussaind
Keyword(s):  
Return To Work ◽  
Operative Time ◽  
Demographic Data ◽  
Open Group ◽  
Anal Stenosis ◽  
Chronic Complications ◽  
Open Method ◽  
Post Operative Pain ◽  
Sex Type ◽  
Primary Variable

OBJECTIVETo compare the operative time and outcomes of Ligasure hemorrhoidectomy with that of the traditional open hemorrhoidectomy.METHODOLOGYA total of 49 patients were included in this study. Out of which 24 were in the Ligasure group and 25 in the open group. The main objective or the primary variable was to assess the operative time for the excision of a single hemorrhoidal lesion, the need for morphine, for post operative pain relief and any other complications such as preoperative bleeding and the time to return to work. The data like age, sex, type of Haemorrhoidectomy, type of complicating etc. were recorded in already prepared proforma. The data was analysed through computer program SPSS10.RESULTSThe demographic data were comparable between the two groups. The time spent in excision of a solitary hemorrhoidal lesion was significantly shorter in the Ligasure group compared to the open group (8.25 min Vs 16.75 min ) and this difference was found to be statistically significant (p<0.001). Operative bleeding was also significantly lower than the open method of Haemorrhoidectony. Other parameters like post operative pain, opioid requirement, urinary retention and chronic complications like anal stenosis and gas incontinence were not significant. There was no difference in the period of convalescence and return to work between the two groups.CONCLUSIONHemorrhoidectomy with the Ligasure entails a shorter surgical time and could be associated with a lesser pain besides being safer.

scholarly journals A retrospective study on laparoscopic appendectomy versus open appendectomy

2019 ◽  
Vol 6 (4) ◽  
pp. 1144
Author(s):  
P. Senthil Kumar ◽  
S. Edwin Kin’s Raj ◽  
Saranya Nagalingam
Keyword(s):  
Retrospective Study ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Laparoscopic Group ◽  
Daily Activities ◽  
Early Return

Background: Appendectomy is the most common surgical procedure performed in emergency surgery. Open appendectomy is the “gold standard” for the treatment of acute appendicitis. Laparoscopic appendectomy though widely practiced has not gained universal approval. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a retrospective study.Methods: The study was done as a retrospective study among 387 patients diagnosed with appendicitis for a period of 18 months in the Dept of General Surgery. All patients included were 16 years and above and followed up for 3 weeks. In this study, 130 patients diagnosed as acute appendicitis - underwent open appendectomy and 257 patients diagnosed as sub-acute cases of appendicitis - underwent laparoscopic appendectomy. These two groups (open & laparoscopic) were compared for operative time, length of hospital stay, postoperative pain, complication rate, early return to normal activity.Results: Laparoscopic appendectomy was associated with a shorter hospital stay (around 4.5 days), with a less need for analgesia and with an early return to daily activities (around 11.5 days). Operative time was significantly shorter in the open group (35 mins), when compared with laparoscopic group (around 59 mins). Total number of complications was less in the Laparoscopic group with a significantly lower incidence of post-op pain and complications.Conclusions: The laparoscopic approach is a safe and efficient operative procedure and it provides clinically beneficial advantages over open appendectomy (including shorter hospital stay, an early return to daily activities and less post-op complications).

Randomized, Single-Blinded Trial of Laparoscopic Versus Open Appendectomy in Children

1997 ◽  
Vol XLI (3) ◽  
pp. 164
Author(s):  
C. LEJUS ◽  
L. DELILE ◽  
V. PLATTNER ◽  
M. BARON ◽  
S. GUILLOU ◽  
...  
Keyword(s):  
Open Appendectomy ◽  
Laparoscopic Versus Open Appendectomy ◽  
Blinded Trial

scholarly journals Laparoscopic versus open appendectomy: a prospective comparative study

2017 ◽  
Vol 18 (2) ◽  
pp. 29-32
Author(s):  
Sumita Pradhan ◽  
Yagya Ratna Shakya ◽  
Hemant Batajoo ◽  
Balram Malla ◽  
Hem Nath Joshi ◽  
...  
Keyword(s):  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Open Appendectomy ◽  
P Value ◽  
Alvarado Score ◽  
Post Operative Pain ◽  
Prospective Comparative Study ◽  
A Prospective Study ◽  
Laparoscopic Versus Open Appendectomy

Introduction: Appendectomy is one of the most commonly performed surgeries usually done by conventional open method. The role of laparoscopic appendectomy is still not well defined in the literature and although widely practiced it still hasn’t gained popularity in Nepal. The aim of this study was to compare the outcomes of laparoscopic versus open appendectomy.Methods: A prospective study was carried out, between August 2013 and September 2014, involving 216 patients (93 males and 123 females) with a diagnosis of acute appendicitis based on Alvarado score of seven and above. Patients were allocated into two groups where every alternate patient was operated either open or laparoscopically. The groups were compared in terms of operative time, post operative pain, post operative complications and length of hospital stay.Results: Open appendectomy (OA) comprised of 106 patients and Laparoscopic appendectomy (LA) comprised of 110 patients. Patients’ characteristics were similar in both groups. The mean operative time in LA was 42.82±10.84 minutes and in OA 37.99±9.81 minutes (p<0.86). Conversion was done in 2.8% of laparoscopic cases. Mean comparison of postoperative pain by visual analogue scale was low in LA compared to OA (P<0.05). Mean post operative stay (3.19±1.26 vs 2.75±0.7, p<0.01) and surgical site infection was recorded in 9 patients (8.5%) in OA group and 3 (2.5%) in LA group, with p value of 0.06.Conclusions: Laparoscopic appendectomy is feasible and safe as open procedure with less post operative pain and shorter hospital stay. Journal of Society of Surgeons of Nepal, 2015; 18 (2), page: 29-32

scholarly journals Comparative Evaluation of Open and Laproscopic Method of Appendectomy in Acute Appendicitis

2020 ◽  
Vol 3 (1) ◽  
pp. 8-11
Author(s):  
Amarnath Gupta ◽  
A P Singh
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Wound Infection ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Oral Feeding ◽  
Open Group ◽  
Abdominal Abscess ◽  
Average Hospital ◽  
Open Operation

Background: There is definitely added advantage of laparoscopic operations. Most of the surgeons now prefer these minimally invasive proce- dures. Laparoscopy has become the number one choice of educated and affording patients. The aim of the study was to compare and evaluate the open and laproscopic method of appendectomy in acute appendicitis. Subjects and Methods: The subjects undergoing appendectomy  were evaluated for age, sex, episode number, duration of pain before presentation in hospital, operative time, conversion rate, wound infection, post-operative intra-abdominal abscess formation, and stay in hospital. Results: It was found that average operative time in open surgery was 67.5 minutes and 104 minutes in laparoscopic surgery, with a conversion to open in about 20% of the cases. Oral feeding in the open group was around the 5th day while it was around 2nd day in the laparoscopic group. Average hospital stay was also low in the laparoscopic group, being only around 5 days in laparoscopic group and around 8 days in the open group. Overall complications were also low in the laparoscopic surgery group. Conclusion: It was noted that though conversion to open operation was definitely high but there were other advantages of laparoscopic surgery as well. Stay in the hospital, beginning of oral feeds, requirement of analgesics, wound infection, intra-abdominal abscess; pulmonary complications were less in laparoscopy group.

scholarly journals Laparoscopic Versusopen Appendectomy - Which One Is Better?

2019 ◽  
Vol 17 (1) ◽  
pp. 7-13
Author(s):  
Md Atiar Rahman ◽  
Md Shahadot Hossain Sheikh ◽  
Md Ibrahim Siddique ◽  
Md Shahidul Islam ◽  
AKM Ahsan Ullah ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Operative Time ◽  
Operative Procedure ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Patient Characteristics ◽  
Laparoscopic Technique ◽  
Analgesia Requirement ◽  
Initial Procedure

Objective: Appendectomy, being the most common surgical procedure performed in general surgery, is still being performed by both open and laparoscopic methods due to a lack of consensus as to which is the most appropriate method. Because further trials are necessary and few such studies have been performed in developing countries, we decided to evaluate the outcomes of the 2 procedures to share our experience with others. Methods: Prospectively collected data from 618 consecutive patients with appendicitis were studied. These comprised of 340 patients who underwent conventional open appendectomy and 260 patients treated laparoscoplcally&18 were excluded because of protocol violations. The two groups were compared with respect to operative time, length of hospital stay, postoperative pain, return to normal work, complication rate and cost. Results: There were no statistical differences regarding patient characteristics between the two groups. Conversion to laparotomy was necessary in 5 patients (1.88%). Laparoscopic appendectomy was associated with a shorter hospital stay (1.5 d vs 2.5 d), lower incidence of wound infection (3.07% vs 8.29%,) &less analgesia requirement. The operative time was more (45.6 vs 24.5 min) and the cost of treatment was higher in the laparoscopic group. Conclusion: The laparoscopic technique is a safe and clinically beneficial operative procedure. It provides certain advantages over open appendectomy, ·including short hospital stay, decreased requirement .of postoperative analgesia, early food tolerance, and earlier return to normal activities, Where feasible, laparoscopy should be undertaken as the initial procedure of choice for most cases of appendicitis. Journal of Surgical Sciences (2013) Vol. 17 (1) : 7-13

scholarly journals Comparison of Therapeutic Effects of Laparoscopic and Open Operation for Congenital Choledochal Cysts in Adults

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Yuan Liu ◽  
Xu Yao ◽  
Shuqiang Li ◽  
Wenhan Liu ◽  
Lei Liu ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Adult Patients ◽  
Open Group ◽  
Therapeutic Effects ◽  
Intraoperative Blood Loss ◽  
Choledochal Cysts ◽  
Cyst Excision ◽  
Postoperative Stay

Background. Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for treating congenital choledochal cysts (CCCs) have proved to be efficacious in children. Its safety and efficacy in adult patients remain unknown. The purpose of this study was to determine whether the laparoscopic procedure was feasible and safe in adult patients.Methods. We reviewed 35 patients who underwent laparoscopic operation (laparoscopic group) and 39 patients who underwent an open procedure (open group). The operative time, intraoperative blood loss, time until bowel motion recovery, duration of drainage, postoperative stay, time until resumption of diet, postoperative complications, and perioperative laboratory values were recorded and analyzed in both groups.Results. The operative time was longer in the laparoscopic group and decreased significantly with accumulating surgical experience (P<0.01). The mean intraoperative blood loss was significantly lower in the laparoscopic group (P<0.01). The time until bowel peristalsis recovery, time until resumption of diet, abdominal drainage, and postoperative stay were significantly shorter in the laparoscopic group (P<0.01). The postoperative complication rate was not higher in the laparoscopic group than in the open group (P>0.05).Conclusions. Laparoscopic cyst excision and hepaticojejunostomy are a feasible, effective, and safe method for treating CCCs in adult patients.

Initial Experience With a New Robotic Surgical System for Cholecystectomy

2019 ◽  
Vol 27 (2) ◽  
pp. 136-142 ◽  
Author(s):  
Ravi Aggarwal ◽  
Jasmine Winter Beatty ◽  
James Kinross ◽  
Alexander von Roon ◽  
Ara Darzi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Haptic Feedback ◽  
Surgical Complication ◽  
Demographic Data ◽  
Operating Time ◽  
Surgical Techniques ◽  
Laparoscopic Group ◽  
Interquartile Range ◽  
Hospital Data

Background. Laparoscopic cholecystectomy has been the gold standard treatment for symptomatic cholelithiasis for more than 3 decades. Robotic techniques are gaining traction in surgery, and recently, the Senhance™ robotic system was introduced. The system offers advantages over other robotic systems such as improved ergonomics, haptic feedback, eye tracking, and usability of standard laparoscopic trocars and reusable instruments. The Senhance was evaluated to understand the feasibility, benefits, and drawbacks of its use in cholecystectomy. Study Design. A prospectively maintained database of the first 20 patients undergoing cholecystectomy with the Senhance was reviewed at a single hospital. Data including operative time, console time, set up time, and adverse events were collected, with clinical outcome and operative time as primary outcome measures. A cohort of 20 patients having laparoscopic cholecystectomy performed by the same surgeon was used as a comparator group. Results. The 2 groups had comparable demographic data (age, sex, and body mass index). In the Senhance group, 19 of the 20 procedures (95%) were completed robotically. The median (interquartile range) total operating, docking, and console times were 86.5 (60.5-106.5), 11.5 (9-13), and 30.8 (23.5-35) minutes, respectively. In the laparoscopic group, the median (interquartile range) operating time was 31.5 (26-41) minutes. Postoperatively, only one patient had a surgical complication, namely a wound infection treated with antibiotics. Conclusion. Our results suggest that Senhance-assisted cholecystectomy is safe, feasible, and effective, but currently has longer operative times. Further prospective and randomized trials are required to determine whether this approach can offer any other benefits over other minimally invasive surgical techniques.

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