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 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 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).

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 Efficacy and Safety of Laparoscopic Appendectomy for Complicated Appendicitis in Children in Tertiary Care Hospital

2018 ◽  
Vol 28 (Number 1) ◽  
pp. 21-26
Author(s):  
Md. Anisuzzaman ◽  
ASM A Kabir ◽  
Md. A R l Sadiq ◽  
Md. A Matin ◽  
I Ahmed ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Complicated Appendicitis ◽  
Safe Procedure ◽  
Care Hospital ◽  
Efficacy And Safety ◽  
The Mean

Laparoscopic appendectomy for uncomplicated appendicitis is associated with good outcomes but the role of laparoscopy in complicated appendicitis is more controversial because of high incidence of infectious complications. The aim of this current study is to evaluate the efficacy and safety of laparoscopic appendectomy in complicated appendicitis in children. This interventional study was carried out during the period from January 2015 to May 2018 in Holy Family Red Crescent Medical College Hospital. The study included 43 patients, age ranges from 3 years to 15 years who underwent laparoscopic appendectomy for complicated acute appendicitis. The following variables were analyzed : age, sex, operative findings, operative time, return of bowel function, resumption of oral feeds, length of hospital stay, postoperative complications such as deur, wound infection and intraabdominal abscess etc. The mean age of studied cases was 7.1 years. In 41 patients (95.3%) the procedure was completed laparoscopically. Two (4.7%) patients required conversion to open appendectomy. The operative time was 83.5+,25.8 minutes. Two patients (4.6%) had post-operative ileus. Four patients (9.7%) developed superficial wound infection. Three patients (7.3%) developed infra-abdominal collections. One (2.4%) patients were readmitted because of recurrent abdominal pain One patients (2.4%) developed postoperative pyrexia due to pneumonitis and Three patients (7.3) developed gastroenteritis. The mean length of hospital stay was 5.8±2.1 days. No mortality was recorded.Laparoscopic appendectomy can be the first choice for cases of complicated appendicitis in children. It is a feasible, safe procedure and is associated with acceptable post-operative morbidity with rapid recovery and better cosmetic results.

scholarly journals Mastering the learning curve significantly reduces operative time for laparoscopic treatment of complicated appendicitis

2021 ◽  
Vol 13 (2) ◽  
Author(s):  
Andrej Nikolovski ◽  
Aleksandar Otljanski ◽  
Rexhep Seljmani ◽  
Svetozar Antovic ◽  
Nikola Jankulovski
Keyword(s):  
Learning Curve ◽  
Laparoscopic Appendectomy ◽  
Postoperative Morbidity ◽  
Operative Time ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Complicated Appendicitis ◽  
Intraabdominal Abscess ◽  
Laparoscopic Treatment ◽  
Operative Method

Laparoscopic appendectomy is the preferred operative method for acute appendicitistreatment. In terms of complicated appendicitis it can be effective in hands of an experiencedlaparoscopist that overwhelmed the learning curve for the method. Aim: Тhis retrospectivestudy examines whether the operative time for laparoscopic appendectomy for complicatedappendicitis is shortened after mastering the learning curve. Material and methods: A totalnumber of 196 patients were operated for the diagnosis of acute appendicitis, of whom 77were diagnosed with complicated appendicitis. They were subsequently divided in two groups(laparoscopic and open). Operative time in both groups was measured and the conversionand postoperative complications were noted. Results: Conversion rate was 2.3%. Operativetime was shorter in the laparoscopic group (67.4 ± 22.9 vs. 77.9 ± 17.9 minutes; p = 0.033).Overall postoperative morbidity was 25.97% with wound infection present only in the opengroup (p = 0.018). Intraabdominal abscess occurred in one patient from the laparoscopicgroup (0.38%). Length of hospital stay was shorter in the laparoscopic group (4.3 ± 2.2 vs. 5.7 ± 2.1, p = 0.0052).  

scholarly journals Single incision laparoscopic appendectomy: A prospective study

2021 ◽  
Vol 12 (12) ◽  
pp. 161-166
Author(s):  
Nilesh P Mangam
Keyword(s):  
Postoperative Complications ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Open Surgery ◽  
Single Incision ◽  
Open Appendectomy ◽  
Surgical Trauma ◽  
Single Incision Laparoscopic Surgery ◽  
Female Ratio ◽  
Time Required

Background: Appendicitis is one of the common pathologies encountered in surgical practice. Except in minority of the cases, the treatment is usually surgical. Till recent past, open appendectomy has been the procedure of choice for appendicitis. With increasing expertise in laparoscopic surgeries more and more surgeons are utilizing the laparoscopic approach for appendectomy. Laparoscopic surgeries have distinct advantages such as less surgical trauma, improved and quick postoperative recovery, and esthetic results. Single-incision laparoscopic surgery (SILS) is rapidly gaining acceptability in young population because of its cosmetic advantages. Moreover, these surgeries also avoid the risk of port-site hernias and the possibility of wound infection. Aims and Objective: The purpose of this study is to present our initial experience with this surgery using a single incision laparoscopic appendectomy (LA) using conventional instruments. Materials and Methods: This was a prospective cohort study conducted in the department of surgery of a tertiary care medical college situated in an urban area. The duration of the study was 2 years. All adult patients diagnosed to be having uncomplicated appendicitis and undergoing appendectomy by SILS were included in this study on the basis of a predefined inclusion and exclusion criteria. Pre-operative data collected included age, sex, weight, duration of complaint, concomitant medical conditions (like ischemic heart disease, chronic obstructive airway disease, diabetes mellitus, pancreatitis, and liver cirrhosis) and previous upper or lower abdominal surgery. All patients were treated by SILS except 1 patient in whom the procedure was converted to open surgery. Mean surgical time, Intraoperative procedure details and postoperative complications were studied in all the cases. p < 0.05 was taken as statistically significant. Statistical analysis was done using SSPS 21.0 software. Results: Out of 30 patients in this study 26 patients were female and 4 patients were male. The male to female ratio was found to be 1:6.15. Mean age of studied cases was found to be 26.2 years. Operative time required for the first 15 cases in an average was 120.00 min however it was reduced for the next 15 cases was 73.73 min. Overall time required in an average was 96.86 min. Out of 30 cases, The procedure was completed with Single Incision LA in 23 Patients, i.e., 76.6 %. In the initial cases, we started with two 5 mm and one 10mm port. To reduce crowding we replaced the 5 mm port to 3 mm port. The 10 mm port was also replaced by 5 mm in the past few cases in 1 patient the procedure was converted to open surgery. The analysis of postoperative complications showed that five patients had Post-Operative wound Infection. One patient had post-operative peritonitis. Conclusion: SILS is a feasible and safe surgical method for appendectomy and is being increasingly preferred particularly by young patients due to its excellent cosmetic results.

Peritonitis from Perforated Appendicitis: Stress Response after Laparoscopic or Open Treatment

2012 ◽  
Vol 78 (5) ◽  
pp. 582-590 ◽  
Author(s):  
Mario Schietroma ◽  
Federica Piccione ◽  
Francesco Carlei ◽  
Marco Clementi ◽  
Zuleyka Bianchi ◽  
...  
Keyword(s):  
Systemic Inflammation ◽  
Laparoscopic Appendectomy ◽  
Neutrophil Elastase ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Laparoscopic Group ◽  
Open Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Hla Dr

Elevated intra-abdominal pressure during laparoscopy may promote systemic inflammatory response. In patients with generalized peritonitis from perforated appendicitis, we sought to compare acute phase response and immunologic status from laparoscopic and open approach. One hundred and forty-seven consecutive patients underwent appendectomy for perforated appendicitis (73 patients had laparoscopic appendectomy and 74 patients had open appendectomy. Bacteremia, endotoxemia, white blood cells, peripheral lymphocytes subpopulation, human leukocyte antigen-DR (HLA-DR), neutrophil-elastase, interleukin-1 and 6 (IL-1 and 6), and C-reactive protein were investigated. One hour after intervention, bacteremia was significantly higher in the open group compared with the laparoscopic group ( P < 0.05). A significantly higher concentration of systemic endotoxin was detected intraoperatively in the open group of patients in comparison with the laparoscopic group ( P < 0.05). Laparotomy caused a significant increase in neutrophil concentration, neutrophil-elastase, IL-1 and 6, and C-reactive protein and a decrease of HLA-DR. We recorded 6 cases (8.1%) of intra-abdominal abscess in the open group and one (1.3%) in the laparoscopic group ( P < 0.05). Open appendectomy, in case of peritonitis, increased the incidence of bacteremia, endotoxemia, and systemic inflammation compared with laparoscopic appendectomy. Early enhanced postoperative systemic inflammation may cause lower transient immunologic defense after laparotomy (decrease of HLA-DR), leading to enhanced sepsis in these patients.

scholarly journals APPENDECTOMY;

2008 ◽  
Vol 15 (04) ◽  
pp. 425-430
Author(s):  
TARIQ WAHAB KHANZADA ◽  
ABDUL SAMAD ◽  
WASEEM MEMON
Keyword(s):  
Prospective Study ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
Length Of Hospital Stay ◽  
Laparoscopic Group ◽  
Wound Infection Rate ◽  
Kingdom Of Saudi Arabia ◽  
The Common

. Objective: The purpose of this prospective study was to compare length of hospital stay, in hospital complications andoperative time between laparoscopic appendectomy (LA) and open appendectomy (OA). Setting: This prospective study was carried out atKing Khalid Hospital, Najran, Kingdom of Saudi Arabia over a period of 26 months from July 2002 to August 2004. Methods: Patients wererandomly divided into laparoscopic and open appendectomy groups and length of stay, operative time and in hospital complications were noted.Results:60 patients underwent laparoscopic appendectomy and 65 underwent open. Operating time was longer in laparoscopic group but lengthof stay was shorter in laparoscopic group. Wound infection was the common complication in both group but it was higher in patients whounderwent open appendectomy. Conclusion: Laparoscopic appendectomy can be performed with morbidity similar to open appendectomyand may actually have decreased wound infection rate.

scholarly journals Laparoscopic versus open appendectomy in children with complicated appendicitis in a tertiary teaching hospital

2020 ◽  
Vol 7 (7) ◽  
pp. 2213
Author(s):  
Pramod Sreekantamurthy ◽  
Bhavana Chinmayee ◽  
Sharath .
Keyword(s):  
Laparoscopic Appendectomy ◽  
Operative Time ◽  
Late Complication ◽  
Open Appendectomy ◽  
Complicated Appendicitis ◽  
Laparoscopic Technique ◽  
Total Leucocyte Count ◽  
Duration Of Symptoms ◽  
Tertiary Teaching ◽  
Significant Difference

Background: Acute appendicitis in children is the most common surgical emergency. Good outcomes have been reported with laparoscopic appendectomy (LA) in children for uncomplicated appendicitis. But the use of laparoscopy for complicated appendicitis in children is more controversial. Higher incidences of postoperative abdominal and wound infections have been reported. The purpose of this study was to retrospectively compare LA and open appendectomy (OA) for complicated appendicitis in children.Methods: The outcome of 73 patients with complicated appendicitis was retrospectively analyzed. There were 36 children in the LA group and 37 in the OA group. Data collection included demographics, duration of symptoms, type of complicated appendicitis, operative time, resumption of diet, early and late complication, length of hospitalization and duration of antibiotic use.Results: No significant difference was found with respect to age, duration of symptoms and total leucocyte count between two groups.  The operative time for LA (55.83±4.81 minutes for LA versus 67.16±4.27 minutes for OA; p=0.0001) was shorter. Patients in the LA group returned to oral intake earlier (2.83±0.31 days for LA versus 3.84±0.33 days for OA; p=0.001) and had a shorter length of hospital stay (5.11±0.55 days for LA versus 7.92±1.06 days for OA; p=0.0001).  The incidence of wound infection in group LA was 5.5% compared to 18.9% in OA group.Conclusions: The laparoscopic technique for complicated appendicitis in children is feasible, safe. Laparoscopic appendectomy should be the initial procedure of choice for most cases of complicated appendicitis in children.

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 &lt; 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 &lt; or = 0.05). Conclusions Laparoscopy did not improve analgesia and postoperative recovery after appendectomy in children.

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