scholarly journals Study of laparoscopic appendectomy: advantages, disadvantages and reasons for conversion of laparoscopic to open appendectomy

2017 ◽  
Vol 4 (3) ◽  
pp. 993
Author(s):  
Sujan Narayan Agrawal ◽  
Sunita Meshram ◽  
Kamlesh Dhruv
Keyword(s):  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Normal Activity ◽  
Organ Injury ◽  
Cross Sectional ◽  
Duration Of Hospital Stay ◽  
Duration Of Surgery

Background:Good outcome has been reported with the laparoscopic approach in uncomplicated appendicitis, but a higher incidence of postoperative intraabdominal abscesses has been reported after laparoscopic appendectomy in complicated appendicitis. Objective was to study the efficacy of laparoscopic appendectomy.Methods: A Hospital based cross sectional study was carried out among of 302 patients. The study duration was from June 2004 to December 2006. Institutional Ethics Committee permission was obtained. Informed individual consent was taken. Out of 302 subjects, 236 underwent open appendectomy and 66 underwent laparoscopic appendectomy.Results:It was observed that in both the groups majority patients had retrocecal position of the appendix. The amount of blood loss, adjacent organ injury and duration of surgery were similar in both the groups. The difference in the incidence of wound infection in both groups was not found to be statistically significant. But the antibiotic use was significantly less in the LA group compared to OA group. It was found that time to resumptions of oral fees, duration of hospital stay and time to return to normal duties were significantly lesser in LA group compared to OA group. (p < 0.001). As per the cosmetic end result, majorities were satisfied in LA group and rated the surgery as excellent as compared to patients in OA group.Conclusions:Laparoscopic appendectomy was better than open appendectomy with respect to wound infection, tackling co-existing pathology, duration of hospital stay, earlier return to normal activity, excellent cosmetic end result, lesser use of antibiotics and earlier resumption of oral feeds.

Association of Wound Infection with Various Surgical Technique Applied for Appendectomy in Diabetic and Hypertensive Patients

2021 ◽  
Vol 15 (8) ◽  
pp. 2163-2165
Author(s):  
Muhammad Armughan ◽  
Imran Sadiq ◽  
Shafqat Mukhtar ◽  
Hafiz Ahmad Altaf
Keyword(s):  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Surgical Procedure ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Diabetic Patients ◽  
Wound Infections ◽  
Hypertensive Patients ◽  
Duration Of Surgery ◽  
Perforated Appendix

Background: Perforated appendix in diabetic as well as hypertensive patients is associated with elevated risks of postoperative infectious complications such as wound infection and intra-abdominal abscess. Objective: To identify better appendectomy procedure for diabetic and hypertensive patients. Study Design: Randomized Controlled Trial Place and Duration of Study: Department of Surgery, Unit l, Bahawal Victoria Hospital Bahawalpur from 10th October 2020 to 9th April 2021. Methodology: Ninety eight patients meeting the criteria of perforated appendix were divided in two groups; one group consisted of 49 patients who were managed by open surgical procedure. Second group was consisted of 49 patients who were managed by laparoscopic surgical procedure. Patient outcomes in-terms of wound infections, operative time and duration of surgery was assessed. Results: Mean age of patients was 25.49±6.03 years. There were 17 hypertensive while 15 diabetic patients. Wound infection was seen in 21% and 28% open surgery diabetic and hypertensive patients respectively in comparison to 10%and 8% in laparoscopic appendectomy diabetic and hypertensive patients respectively (p<0.001). Conclusion: Laparoscopic appendectomy (LA) is associated with significantly lower rates of post-operative wound infections and shorter hospital stay in comparison to open appendectomy in diabetic and hypertensive patients of perforated appendicitis. Key Words: Perforated appendix, laparoscopic, open appendectomy

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 LAPAROSCOPIC AND OPEN APPENDECTOMY

2016 ◽  
Vol 23 (11) ◽  
pp. 1305-1310
Author(s):  
Nawaz Ali Dal ◽  
Qamber Ali Lighari ◽  
Zameer Hussain Laghari
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Iliac Fossa ◽  
Open Appendectomy ◽  
Normal Activity ◽  
University Hospital ◽  
Rebound Tenderness ◽  
Co Morbidity ◽  
The Mean

Objectives: Objectives of this study are to compare the outcome of thelaparoscopic with open appendectomy in terms of postoperative pain, postoperativecomplications and hospital stay. Study Design: Randomized control trial. Place and Periodof Study: This study was held in Surgical Unit-III, Liaquat University Hospital Jamshoro, fromSeptember 2013 to March 2014. Methodology: This study comprised of sixty patients admittedvia outpatient department, and also through casualty department of LUHMS Jamshoro/Hyderabad. Cases were categorized into 2 groups. Group-A for open appendectomy andgroup-B for laparoscopic appendectomy. Comprehensive History was obtained from eachpatient. Right iliac fossa site was particularly assessed for tenderness assessment at Mc: Burney’spoint rigidity rebound tenderness and documented through proforma. A comprehensive reviewwas as well performed to observe any co-morbidity. Inclusion criteria comprised of all thosepatients of acute appendicitis who give written consent for study after counseling, irrespectiveof their age and sex. Criteria for exclusion included each patient with aspects of specifiedperitonitis, cases with obvious mass within right iliac fossa as well as cases with pre-operativehistory of lower abdomen or caesarean section. Outcomes were documented in the term ofterms of postoperative pain, postoperative complications and hospital stay and recorded onPerforma. Data analyzing was carried out with SPSS software. Results: From totally 60 casesin our study 40 patients males (66.67%) and 20 were females (33.33%); with female to maleproportion of 1:3. There was an extensive variation in age from 10 to 70 years among bothgroups. The mean age was 26.78 years. Both groups were symptomatically nearly similar withpain in RIF, pain initiating around umbilicus, nausea, vomiting, anorexia, fever, and modifiedbowel behavior, in 59 (98.33%), 45 (75%), 50 (83.33%), 35 (58.33%), 25 (41.67%), 22 (36.67%),20 (33.33%) respectively. Clinical assessment of cases exposed tenderness at Mc Burney’spoint in 59 (98.33%) cases, muscle guarding in 52 (86.67%) cases, rebound tenderness in55 (91.67%) cases and fever in 20 (33.33%) patients. Operative period in each group wasdocumented that ranged from 30 to 90 min. in each group. The mean operative period in OAgroup was 38.90+15.90 where as it was 26.30+12.96 minutes LA group. Post-operative painseverity in each group was documented. Mild pain was found in 5(16.67%) in OA group casesand 21 (70%) in LA group cases was noted, moderate pain in 22(73.33%) OA group casesand 9(30%) LA group cases was noted, severe pain was described by 3 (10%) patients in OA.The period of return to normal activity in open appendectomy ranged from 7-25 days (mean14.8 days) as contrasted to laparoscopic appendectomy (LA) group where it varied from 7-15days. Conclusion: In conclusion, we exhibited that LA has significant

scholarly journals A comparative study of laparoscopic appendectomy versus open appendectomy

2019 ◽  
Vol 7 (1) ◽  
pp. 138
Author(s):  
Reina Khadilkar ◽  
Ashwini Anil Panditrao ◽  
Ramteja Inturi
Keyword(s):  
Acute Appendicitis ◽  
Comparative Study ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Research Centre ◽  
Total Leukocyte Count ◽  
College Hospital ◽  
Early Return ◽  
Duration Of Surgery

Background: Obstruction of appendiceal lumen resulting in acute appendicitis is diagnosed by clinical examination, supported by raised neutrophil count, computed tomography and/or ultrasonography.Appendectomy one of the most commonly done surgeries is the standard line of management for acute appendicitis. Trend is towards greater utilization of laparoscopic appendectomy despite lack of consensus on superiority of laparoscopic procedure, hence imperative to prove scientifically the effectiveness of the two methods. The aim of the present study was a comparative study of laparoscopic appendectomy versus open appendectomy.Methods: A prospective cohort study of 100 cases of acute appendicitis above 16 years of age with no co morbidities was carried out in Dr. D. Y. Patil Medical College, Hospital and Research Centre from July 2017 to September 2019.Results: Mean age was 28.82 years, 64 (64%) males and 36 (36%) females, pain in abdomen (100%) being most common complaint followed by fever (77%) with positive correlation with severity of appendicitis (Alvarado score) and with total leukocyte count. Mean duration of surgery and hospital stay in laparoscopic appendectomy was lesser than open and difference was statistically highly significant (p=0.000). No difference in pain score observed. Retrocaecal (58%) was the most common position, slightly higher rate of complications in open appendectomy, no conversion of laparoscopic to open. Subjective level of satisfaction score (0-10) in laparoscopic appendectomy was higher than in open and difference was statistically highly significant (p=0.000).Conclusions: Laparoscopic appendectomy had advantages like better cosmesis, shorter duration of procedure and hospital stay, fewer post-operative complications and early return to work with disadvantage of steep learning curve, while open appendectomy, does not require special instruments, and is performed under direct three-dimensional vision.

PERITONEAL CLOSURE VERSUS NON-CLOSURE IN OPEN APPENDICECTOMIES

2021 ◽  
pp. 11-12
Author(s):  
V. Manmadha Rao M.S ◽  
D. N. S. Sai Kumar ◽  
K. Neelesh
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Wound Infection ◽  
Operative Time ◽  
Open Appendicectomy ◽  
Duration Of Hospital Stay ◽  
Peritoneal Closure ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
King George Hospital

Acute Appendicitis is a common surgical emergency and Open Appendicectomy is widely performed. This study aims to analyze the difference of outcome in peritoneal closure versus Non closure in open appendicectomy. Adult patients (18- 65 years) admitted and operated for Acute appendicitis were studied prospectively from July 2019 to July 2020 at King George Hospital, Visakhapatnam. The intra operative time, post-operative pain, wound infection and duration of hospital stay were analyzed. Between July 2019 and July 2020 there were 86 patients with diagnosis of Acute appendicitis to the emergency casualty of KGH, Visakhapatnam and underwent Open appendicectomy. They were divided into two groups randomly, Group A: Open appendicectomy with peritoneal closure (39) and Group B: Open appendicectomy with non-closure of peritoneum (47). There was found to be a reduction in the duration of surgery, less post operative pain and shorter duration of hospital stay in patients who underwent non-closure of peritoneum compared to patients who underwent peritoneal closure. There was no difference in incidence of post-operative wound infection when compared to closure of peritoneum. Non closure of peritoneum is associated with shorter operative time, reduced requirement of post-operative analgesia and shorter duration of hospital stay and hence can be safely recommended.

scholarly journals Comparison of laparoscopic appendectomy versus open appendectomy in acute appendicitis in obese diabetic patients

2020 ◽  
Vol 10 (3) ◽  
pp. 145-148
Author(s):  
Mohammuddunnobi ◽  
Tasnuva Jahan ◽  
Abdullah Al Amin
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendectomy ◽  
Operating Time ◽  
Open Appendectomy ◽  
World Health ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Post Operation

Background: Acute appendicitis (AC) is a common surgical problem requiring emergency hospitalization for urgent appendectomy. In case of diabetic patients, the incidence of developing acute appendicitis including its complications like abscess, gangrene and perforation is higher than non-diabetic. Day by day, laparoscopic appendectomy is having an improved outcome in non-diabetic and non-obese patients. The aim of this study was to compare the outcomes of laparoscopic appendectomy versus open appendectomy in acute appendicitis of obese diabetic patients. Methods: A comparative study was carried out in a tertiary care hospital in Dhaka City. Hospitalized obese diabetic patients with a diagnosis of acute appendicitis, who underwent appendectomy, were considered as study population. Obesity was defined as body mass index (BMI) greater than 30 kg/m2 according to World Health Organization and American Obesity Association guidelines. Patients were divided into two groups according to type of appendectomy; 50 patients by laparoscopic appendectomy as group LA and 50 patients by open appendectomy as group OA. Results: Most patients were obese I (30.0-34.9 kg/m2) in group LA and OA (92.0% and 86.0%, respectively, p<0.05). Uncontrolled diabetes mellitus was detected in most of the patients of both group LA (96.0%) and OA (98.0%). Mean operation time, mean duration of post-operation ileus, mean hospital stay and post-operation complications were less in group LA than group OA which is statistically significant (p< 0.05). No patient developed wound infection after laparoscopic appendectomy; whereas, 8.0% patients had wound infection in open appendectomy (p<0.05). Conclusion: In this study, laparoscopic appendectomy had good outcome over its open counterpart regarding shorter operating time, hospital stay, less wound infection, postoperative pain and time to return to usual activities. Birdem Med J 2020; 10(3): 145-148

scholarly journals A retrospective comparative study of laparoscopic appendectomy and open appendectomy

2018 ◽  
Vol 5 (7) ◽  
pp. 2612
Author(s):  
R. V. Bhosle ◽  
Ganesh Ganpatrao Degloorker
Keyword(s):  
Postoperative Complications ◽  
Laparoscopic Appendectomy ◽  
Demographic Data ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Normal Activity ◽  
Standard Data ◽  
Early Return ◽  
Hospitalization Period

Background: Appendectomy is the most common surgical procedure performed in emergency surgery. Appendectomy is the treatment of choice, which can be done either by open or laparoscopic approach. Controversies till exist as to which is the better choice among the two surgical procedures for treating appendicitis. In this retrospective analysis, we aimed to compare outcomes of laparoscopic appendectomy with open appendectomy.Methods: Total 120 appendectomy cases were analyzed retrospectively in a period of 2 years. The study was conducted in the department of surgery and Institutional ethical committee approval was obtained. Patient demographic data, intraoperative findings and postoperative clinical outcomes were collected standard data sheet. Biopsy specimens were sent to pathology department for histopathological evaluation to confirm the appendicitis.Results: There was no statistical difference found in demographic data of patient’s undergone appendectomy in both (OA and LA) procedures. The overall incidences of postoperative complications were significantly lower (P=.005) in laparoscopic appendectomy. The length of hospital stay was much shorter in laparoscopic appendectomy (3.5 days) when compared with open appendectomy (6.2 days).Conclusions: The laparoscopic appendectomy was better than open or conventional appendectomy with respect to less pain, shorter hospitalization period, minimal postoperative complications and early return to normal activity.

Advantages of Laparoscopic Appendectomy in the Elderly

2006 ◽  
Vol 72 (6) ◽  
pp. 474-480 ◽  
Author(s):  
Andrew G. Harrell ◽  
Amy E. Lincourt ◽  
Yuri W. Novitsky ◽  
Michael J. Rosen ◽  
Timothy S. Kuwada ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Perforated Appendicitis ◽  
Laparoscopic Approach ◽  
The Elderly ◽  
Adult Patients ◽  
Perioperative Outcomes ◽  
Skilled Nursing ◽  
Total Charges

Laparoscopic appendectomy (LA) has gained in popularity in recent years. The number of elderly patients undergoing appendectomy has increased as that segment of the population has increased in number; however, the utility and benefits of LA in the elderly population are not well established. We hypothesized that LA in the elderly has distinctive advantages in perioperative outcomes over open appendectomy (OA). We queried the 1997 to 2003 North Carolina Hospital Association Patient Data System for all patients with the primary ICD-9 procedure code for OA and LA. Patients ≥65 years of age (elderly) were identified and reviewed. Outcomes including length of stay (LOS), charges, complications, discharge location, and mortality were compared between the groups. There were 29,244 appendectomies performed in adult patients (>18 years old) with 2,722 of these in the elderly. The annual percentage of LA performed in the elderly increased from 1997 to 2003 (11.9–26.9%, P < 0.0001). When compared with OA, elderly patients undergoing LA had a shorter LOS (4.6 vs 7.3 days, P = 0.0001), a higher rate of discharge to home (91.4 vs 78.9%, P = 0.0001) as opposed to a step-down facility, fewer complications (13.0 vs 22.4%, P = 0.0001), and a lower mortality rate (0.4 vs 2.1%, P = 0.007). When LA was compared with OA in elderly patients with perforated appendicitis, LA resulted in a shorter LOS (6.8 vs 9.0 days, P = 0.0001), a higher rate of discharge to home (86.6 vs 70.9%, P = 0.0001), but equivalent total charges ($22,334 vs $23,855, P = 0.93) and mortality (1.0 vs 2.98%, P = 0.10). When elderly patients that underwent LA were compared with adult patients (18–64 years old), they had higher total charges ($16,670 vs $11,160, P = 0.0001) but equivalent mortality (0.37 vs 0.15%, P = 0.20). The use of laparoscopy in the elderly has significantly increased in recent years. In general, the safety and efficacy of LA is demonstrated by a reduction in mortality, complications, and LOS when compared with OA. The laparoscopic approach to the perforated appendix in the elderly patient has advantages over OA in terms of decreased LOS and a higher rate of discharge to home as opposed to rehabilitation centers, nursing homes, or skilled nursing care. When compared with all younger adults, the laparoscopic approach in the elderly was associated with equal mortality rates even though hospitalization charges were higher. Laparoscopy may be the preferred approach in elderly patients who require appendectomy.

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