Comparative study and outcome of open versus laparoscopic appendectomy: case series of 60 patients

Background: Laparoscopic appendectomy combines the advantages of diagnosis and treatment in one procedure with least morbidity. Patients are likely to have less postoperative pain and to be discharged from hospital and return to activities of daily living sooner than those who have undergone open appendectomy.Methods: This prospective study was carried out in the Department of Surgery, Heritage IMS, Varanasi, from May 2016 to May 2017. All the patients were randomly divided into two groups, Group I (Lap App) and Group II (Open App). All quantitative data was compared by independent sample test. All qualitative data was compared by chi-square test. A p-value <0.05 was considered statistically significant.Results: In present study 19 (63%) patients of open appendectomy and 19 (63%) patients of laparoscopic appendectomy were males. 11 (36%) patients of open appendectomy and 11 (36%) laparoscopic appendectomy were females.Conclusions: This study from May 2016 to April 2017 was done on 60 (30 lap and 30 open) patients with clinical diagnosis of acute appendicitis admitted in surgical wards of Heritage Institute of Medical Sciences. In spite of drawback of the increase in duration of surgery, we conclude that laparoscopic appendectomy is better than the open method for acute appendicitis, with less post-operative pain and reduced duration of analgesics used, with lesser incidences of post-operative complications, shorter duration of hospital stays, early return to normal work.

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A comparative study of laparoscopic appendectomy versus open appendectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20195959 ◽

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.

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A retrospective study on laparoscopic appendectomy versus open appendectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20191127 ◽

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).

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Comparison between laparoscopic and open appendectomy in pregnant women

International Surgery Journal ◽

10.18203/2349-2902.isj20171609 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1623

Author(s):

Subba Rao Dova ◽

Sankara Rao Pagoti ◽

Manoj Kumar Mannem

Keyword(s):

Acute Appendicitis ◽

Pregnant Women ◽

Laparoscopic Appendectomy ◽

Open Appendectomy ◽

Fetal Loss ◽

P Value ◽

Open Approach ◽

Open Procedure ◽

Gestational Age At Delivery ◽

Group 2

Background: Acute appendicitis is the most common indication for surgical emergency in normal patients and also in pregnant women. The objective of this study was to study the clinical significance of a laparoscopic over an open approach to appendicectomy pregnant population.Methods: Total 46 cases patients with acute appendicitis confirmed the diagnosis by clinical examination and ultrasonography. The patients were divided into two groups laparoscopic appendectomy (group 1) n=21 and Open appendectomy (group 2) n=25. We retrospectively analyzed the medical records to compare the 2 groups.Results: All the demographic details are not significant when compared with each other. Laparoscopic appendectomy is significantly i.e. <p-value <0.05 less time for operation, length of stay in hospital and complication when compared with open procedure. Time to first flatus, leucocyte and neutrophil ratio are not significantly when compared laparoscopic appendectomy and open appendectomy. Preterm delivery, birth weight, APGAR score, gestational age at delivery, delivery type, fetal loss and maternal death were not significant when compared laparoscopic appendectomy and open appendectomy.Conclusions: Laparoscopic procedure is safe and effective technique for the treatment of appendicitis during pregnancy with nearly similar rates of complications compared to open procedure. Laparoscopic appendectomy associated with shorter hospital stay, faster return to daily activities and shorter time to first flatus.

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Comparison of open versus laparoscopic appendectomy in terms of post operative pain and operative duration.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.10.3534 ◽

2019 ◽

Vol 26 (10) ◽

pp. 1706-1711

Author(s):

Saddaqat Hayat ◽

Osman Riaz ◽

Muhammad Usman ◽

Muhammad Faisal Bilal Lodhi ◽

Asrar Ahmad Khan

Keyword(s):

Laparoscopic Appendectomy ◽

Operating Time ◽

Open Appendectomy ◽

P Value ◽

Operative Duration ◽

Post Operative Pain ◽

History Of ◽

Group A ◽

Group B ◽

Open Versus

Objectives: To measure the results of open appendectomy and laparoscopic appendectomy regarding mean postoperative pain and mean operative duration in the treatment of acute appendicitis. Study Design: Randomized clinical trial. Setting: Surgical unit Allied hospital Faisalabad. Period: June 2016 to December 2016. Material and Methods: 70 patients with appendicitis were included in the study through non-probability consecutive sampling. Patients with history of long standing pain, intake of analgesics (>3 times per week for >3 months) before surgery and patients in whom laparoscopic surgery was contraindicated were excluded. Patients were randomized in group A and group B. Open appendectomy was done in group A and laparoscopic appendectomy was carried in group B. Outcomes in terms of post-operative pain at visual analogue scale and operating time in minutes was measured. Results: Mean age was 28.50 years with standard deviation of 12.283. There were 32 (45.71%) patients were male and 38 (54.29%) patients were females. Post-Operative pain was 7.34±2.014 in group A and 3±1.94 in group B with p-value=0.0001. Operative time in group A was 42.33±4.25 minutes and group B had time of 34.48±3.5 minutes with p-value=0.0001. Conclusion: Laparoscopic appendectomy is superior to open appendectomy considering pain after surgery and time of surgery in patients with appendicitis.

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CHOOSING A METHOD OF SURGICAL TREATMENT OF ACUTE APPENDICITIS IN PATIENTS WITH CONCOMITANT PULMONARY PATHOLOGY

Kharkiv Surgical School ◽

10.37699/2308-7005.1.2020.28 ◽

2020 ◽

pp. 165-168

Author(s):

Y. Hasan ◽

I. E. Borodayev ◽

V. V. Kolodiy ◽

V. N. Kachanov ◽

V. B. Volkov

Keyword(s):

Surgical Treatment ◽

High Risk ◽

Acute Appendicitis ◽

Laparoscopic Appendectomy ◽

Open Appendectomy ◽

Optimal Method ◽

Cardiopulmonary Disease ◽

Abdominal Organs ◽

Group I ◽

Pulmonary Pathology

Summary. The article analyzes the experience of using endovideosurgical method of treatment of patients with АA with pulmonary pathology, determines the indications for the use of different methods of applying pneumoperitoneum when performing laparoscopic appendectomy (LA). Material and method. The result of treatment of 46 patients with acute appendicitis (АA) and concomitant pulmonary pathology in the last 5 years is given. Group I included 14 patients diagnosed with AA with concomitant pulmonary pathology who underwent open appendectomy, and II — 32 patients with a diagnosis of AA with concomitant pulmonary pathology, who underwent laparoscopic appendectomy with the imposition of pneumoperitoneum and metaphormia. Result. The evaluation of the treatment of 32 patients (84.8 %) with concomitant pulmonary pathology performed by LA, which allowed to dramatically reduce the number of complications from the abdominal organs, as well as to reduce the frequency of decompensation of concomitant pulmonary pathologies. Conclusions. Performing a laparolifting laparoscopic appendectomy is the optimal method for patients at high risk for cardiopulmonary disease.

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Tactical approaches to the surgical treatment of patients with complicated forms of acute appendicitis and abdominal sepsis with a high risk of cardiopulmonary insufficiency

Modern medical technologies ◽

10.34287/mmt.2(41).2019.24 ◽

2019 ◽

Vol 41 part 2 (2) ◽

pp. 44-48

Author(s):

B. S. Zaporozhchenko ◽

Khasan Yakhia ◽

I. E. Borodaev ◽

V. N. Kachanov ◽

A. A. Vasiliev

Keyword(s):

High Risk ◽

Acute Appendicitis ◽

Laparoscopic Appendectomy ◽

Standard Procedure ◽

Abdominal Cavity ◽

Open Appendectomy ◽

Abdominal Sepsis ◽

Group I ◽

Almost All ◽

Complicated Acute Appendicitis

Purpose of the study. To determine the feasibility and effectiveness of the laparoscopic method of treatment of patients with complicated forms of acute appendicitis. in patients with high risk of cardiopulmonary failure and to determine the indications for the use of various methods of laparoscopic appendectomy. Materials and methods. The result of treatment of 67 patients with acute appendage with high risky cardiopulmonary insufficiency. Of these, 10 patients (14,9%) were diagnosed with sepsis. The patients were divided into two groups: Group I: 29 (43,3%) patients with complicated acute appendicitis, with a high risk of cardiopulmonary insufficiency, who underwent open appendectomy. Open appendectomy was performed according to the standard procedure from the Volkovich-Dyakonov (Mac-Burney) incision in 19 (65,5%) patients, in 10 (34,5%) median laparotomy. Group II: 38 (56,7%) patients with complicated acute appendicitis who underwent laparoscopic appendectomy, and drainage of the abdominal cavity. Classical laparoscopic surgery with the imposition of pneumoperitoneum was performed in 20 (29,8%) patients and using the laparolifting method in 18 (26,9%) patients Results. 38 (56,7%) patients were operated on using laparoscopic techniques. During laparoscopic interventions, intraoperative revision and appendectomy were performed. This technique is absolutely safe, reliable and affordable in the performance of most surgeons. Conclusions. Laparoscopic appendectomy with complicated forms of acute appendicitis can be performed in almost all patients with acute appendicitis with a high risk of cardiopulmonary insufficiency. Keywords: acute appendicitis, complicated appendicitis, appendectomy, cardiopulmonary insufficiency, laparoscopy. sepsis.

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Compare the Outcomes of Laparoscopic and Open Appendectomy

10.53350/pjmhs211571742 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1742-1744

Author(s):

Aqeel Ahmad ◽

Muhammad Hammad Muzaffar ◽

Mumtaz Ahmad Khan ◽

Arshid Mahmood

Keyword(s):

Acute Appendicitis ◽

Surgical Site Infection ◽

Hospital Stay ◽

Laparoscopic Appendectomy ◽

Open Appendectomy ◽

Site Infection ◽

Time Duration ◽

Group I ◽

Significant Difference ◽

Group Ii

Aim: The aim of this study is to compare the surgical site infection, hospital stay and time duration of procedure in patients undergoing laparoscopic and open appendectomy. Study Design: Prospective/ Observational Place & Duration: Department of Surgery, Pak Red Crescent Medical and Dental college, Dina Nath, during from Jan 2020 to March 2021. Methods: In this study 240 patients of both genders with ages >10 years presented with acute appendicitis were included. Patients demographic including age, sex and body mass index were recorded after written consent. Patients were equally divided into two groups. Group I consist of 120 patients and received laparoscopic appendectomy and Group II with 120 patients received open appendectomy. Outcomes such as surgical site infection, hospital stay and time duration of procedure were examined and compare the results between both groups. Data was analyzed by SPSS 23.0. P-value <0.05 was set as significant. Results: There were 140 (58.3%) patients (70 Group I, 70 Group II) were male with mean age 25.7+6.54 years while 100 (41.7%) patients (50 Group I, 50 Group II) were females with mean age 26.9+3.12 years. No significant difference regarding BMI between both groups p=>0.05. There was a significant difference in term of surgery time duration between both groups 48.24+9.59 minutes Vs 35.74+6.86 minutes; P=0.001. No significant difference observed in term of hospital stay (p=0.345). 11 (9.2%) patients in Group II in which 5.83% had Superficial SSI and 3.7% had Deep SSI. 9 (7.5%) patients 5% superficial and 2.5% Deep SSI in Group I had developed surgical site infection with no significant difference (p=0.41). Conclusion: We concluded in this study that open appendectomy is better in term of operative time as compared to laparoscopic appendectomy. We found no significant difference regarding surgical site infection and hospital stay. Keywords: Acute appendicitis, Appendectomy, Laparoscopic, Open, Outcomes

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Comparative evaluation of appendectomy procedure results with open and laparoscopic access in the treatment of acute appendicitis

Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH) ◽

10.20340/vmi-rvz.2021.2.clin.8 ◽

2021 ◽

Vol 11 (2) ◽

pp. 42-49

Author(s):

S. A. Stolyarov ◽

V. A. Badeyan ◽

М. I. Popova ◽

М. A. Kochoyan ◽

О. A. Zimin ◽

...

Keyword(s):

Acute Appendicitis ◽

Laparoscopic Appendectomy ◽

Comparative Evaluation ◽

Open Surgery ◽

Open Appendectomy ◽

Length Of Hospital Stay ◽

Daily Activities ◽

Laparoscopic Technique ◽

Technical Feasibility ◽

Duration Of Surgery

Relevance of the topic: Appendectomy is one of the most frequently performed operations in abdominal surgery. Laparoscopic access is gradually replacing open surgery for acute appendicitis. The aim of this study was to assess the technical feasibility and safety of the laparoscopic technique for acute appendicitis and compare its results with open appendectomy. A total of 120 patients with acute appendicitis were operated on, 60 with laparoscopic appendectomy and 60 with open surgery. For three years from June 2018 to January 2021. The two groups were compared for the duration of surgery, length of hospital stay, postoperative pain, complication rate, time spent resuming daily activities, and cosmetic satisfaction of patients. The results were found to be significantly better when using the laparoscopic technique. In the postoperative period, there was a lower level of pain, faster recovery, early resumption of work, a decrease in postoperative complications and better cosmetic satisfaction of patients operated on by the method of laparoscopic appendectomy, compared with open surgery. Conclusions: Laparoscopic appendectomy is a safe and feasible technique for treating acute appendicitis with results comparable to open appendectomy, without an obvious increase in complications and is clearly the procedure of choice for treating acute appendicitis.

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Compare Laparoscopic and Open Appendectomy in Terms of Surgical Site Infection

10.53350/pjmhs211582375 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2375-2377

Author(s):

Muhammad Yousaf ◽

Shahid Khan Afridi ◽

Gul Sharif ◽

Wasim Ahmad ◽

Shoaib Muhammad ◽

...

Keyword(s):

Acute Appendicitis ◽

Surgical Site Infection ◽

Hospital Stay ◽

Laparoscopic Appendectomy ◽

Open Appendectomy ◽

Site Infection ◽

Time Duration ◽

Group I ◽

Significant Difference ◽

Group Ii

Aim: The aim of this study is to compare the outcomes between laparoscopic and open appendectomy in terms of surgical site infection. Study Design: Prospective/ Observational Place & Duration: Department of Surgery, Lady Reading Hospital, Peshawar for duration of six months from January 2021 to June 2021. Methods: In this study 200 patients of both genders with ages >10 years presented with acute appendicitis were included. Patients’ demographics including age, sex and body mass index were recorded after written consent. Patients were equally divided into two groups. Group I consist of 100 patients and received laparoscopic appendectomy and Group II with 100 patients received open appendectomy. Outcomes such as surgical site infection, hospital stay and time duration of procedure were examined and compare the results between both groups. Data was analyzed by SPSS 26.0. P-value <0.05 was set as significant. Results: There were 120 (60%) patients (60 Group I, 60 Group II) were males while 80 (40%) patients (40 Group I, 40 Group II) were females. Mean age in group I was 27.9+4.45 years and in group II mean age was 28.5+4.21 years. Mean BMI in group I was 24.08+8.22 kg/m2 and in group II mean BMI was 25.03+6.17 kg/m2. There was a significant difference in term of surgery time duration between both groups 42.88+13.75 minutes Vs 33.35+9.55 minutes; P=0.003.Hospital stay was greater in group II 6.03+3.12 days as compared to group I 4.07+6.13 days. Post operatively less SSI was found among laparoscopic group 6 (6%) in which 4% had superficial SSI and 2% had deep SSI as compared to group II 12 (12%) SSI was found among in which 8% had superficial SSI and 4% had deep SSI. Conclusion: We concluded in this study that laparoscopic appendectomy is better in terms of less hospital stay with less surgical site infection as compared to open appendectomy. We found that less operative time was observed in open appendectomy as compared to laparoscopic. Keywords: Appendectomy, Outcomes, Laparoscopic, Open, Acute appendicitis

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Comparison of open versus laparoscopic appendectomy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20182301 ◽

2018 ◽

Vol 6 (6) ◽

pp. 2133

Author(s):

P. S. Khatana ◽

Jitendra Kumar ◽

Manish Aggarwal

Keyword(s):

Acute Appendicitis ◽

Laparoscopic Appendectomy ◽

Gall Stone ◽

Operating Time ◽

Open Appendectomy ◽

Length Of Hospital Stay ◽

Laparoscopic Group ◽

Stone Disease ◽

Significant Difference ◽

Open Versus

Background: Although laparoscopic cholecystectomy has now considered the gold standard for the management of gall stone disease, laparoscopic appendectomy has not attained the same degree of popularity and acceptance. Aim of this study is to assess and compare the role of laparoscopic appendectomy with open appendectomy in acute appendicitis as well as in the patients planned for interval appendectomy.Methods: Total number of fifty cases over the age of 12 years were studied prospectively. Out of 50 number of total cases, 20 cases were those who have been operated laparoscopically while 30 cases were of open appendectomy group. The two groups were compared with respect to operative time, length of hospital stay, post-operative pain and nausea, complication rate and time to return to normal activity.Results: The mean age was 22.8±2(6.83) and 26.7±2(9.22) years in the laparoscopic and open groups respectively, with the range of 14 to 42 in the laparoscopic group and 13 to 50 years in the open group. The Average operating time was more in the laparoscopic appendectomy as compared to the time taken in performing open appendectomy. However, this was not statistically significant with p<0,05. Overall, there was no significant difference in the incidence of complications between open and laparoscopic groups.Conclusions: The laparoscopic appendectomy is safe, simple and efficient technique for treatment of acute appendicitis with result comparable to the open appendectomy, if not better.

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