scholarly journals Laparoscopic versus open appendicectomy: a non-randomized comparative study

2020 ◽  
Vol 7 (6) ◽  
pp. 1925
Author(s):  
Swatej Hanspal ◽  
M. Yunus Shah ◽  
Murtaza Akhtar
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Wound Infection ◽  
Operative Time ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Conventional Technique ◽  
Laparoscopic Appendicectomy ◽  
Open Appendicectomy ◽  
Number Of Patients

Background: Appendicectomy is one of the most common surgical procedures performed in emergency surgery. Despite this, there is still lack of consensus about the most appropriate technique for appendicectomy. In this longitudinal analysis, we aimed to compare the outcomes of laparoscopic appendicectomy (LA) and the conventional technique or open appendicectomy (OA) in the treatment of acute appendicitis.Methods: A non-randomized longitudinal comparative study was conducted in NKP Salve Institute of Medical Sciences and Lata Mangeshkar Hospital, Nagpur, India. From November 2017 to October 2019, 53 patients underwent OA and 59 underwent LA, making a total number of patients included in this study to be 112 (n). The two groups were compared for operative time, length of hospital stay, postoperative pain, post-operative ileus and complication rate.Results: Laparoscopic appendicectomy was associated with a shorter hospital stay (4.34±1.37 days in LA and 5.09±1.71 days in OA, p<0.01), with a lower post operative pain score [VAS] (2.93±0.80 in LA and 4.62±0.92 in OA, p<0.001). Operative time was shorter in the open group (42.70±12.05 min in OA and 43.39±16.59 in LA). Complications were lesser in the LA group with a significantly lower incidence of wound infection (3.4% in LA and 13.2% in OA).Conclusions: Laparoscopic approach is safe and efficient in appendicectomy and it provides clinically advantages over open method (shorter hospital stays, lower post op pain, early food tolerance, earlier return to work and lesser wound infection) against only marginally longer operative time.

scholarly journals Comparative study on open appendicectomy versus laparoscopic appendicectomy in a tertiary care centre

2018 ◽  
Vol 5 (4) ◽  
pp. 1240
Author(s):  
Naraintran S. ◽  
Sandeep Kumar David S. ◽  
Raveendran K. ◽  
Eashwara Pilla B. K.
Keyword(s):  
Comparative Study ◽  
Hospital Stay ◽  
Wound Infection ◽  
Laparoscopic Appendicectomy ◽  
Open Group ◽  
Open Appendicectomy ◽  
Group 4 ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Post Operative Complications

Background: Appendicectomy is one of the most common procedure in general surgery, accounts for approximately 1% of all surgical operation. Laparoscopic appendicectomy are likely to have less postoperative pain, early discharge, decreased wound infection, better cosmesis and also early return to routine work. Laparoscopic procedure for appendicectomy is compared with open surgical technique with respect to duration of surgery, post operative pain, duration of analgesic, post operative complications, post operative length of hospital stay and return to routine work.Methods: This is a prospective and comparative study from September 2013 to August 2014 involved 100 cases, 50 open and 50 lap appendicectomy, which were randomly selected and were operated in department of surgery, Dr S. M. C. S. I. Medical College, Karakonam.Results: In present study pain score was 2.7±0.9 for open group as compared to 1.3±0.5 in lap group (P<0.05) because of longer incision stretch of muscles and wound infection. Post operative complications like vomiting was lower in laparoscopic group with 8% as compared with 36% in open group (P<0.05) and ileus was lower in lap group with 17.3±7.1 and for open group 30.8±8.9 with P<0.05 which were significant. There is significant reduction in incidence of post operative wound infection in lap group 4% as compared to open group 26% (P<0.05). Duration of post operative hospital stay was significantly low for lap group 2.8±0.9 as compared to open group 4±2.9. The return to normal activity was low for lap group 8±3.15 days as compared to open group 13.7±3.15 days. Duration of surgery for open appendicectomy was 48.2±12.4 and for lap appendicectomy was 68.5±20.3.Conclusions: Laparoscopic appendicectomy is better than open appendectomy in selected patients with acute or recurrent appendicitis.

scholarly journals Laparoscopic versus open surgical approach of cholecystectomy in patients with symptomatic cholelithiasis: a systematic review of comparative trials

2021 ◽  
Vol 7 (3) ◽  
pp. 167
Author(s):  
Omer A. Marzoug
Keyword(s):  
Systematic Review ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
P Value ◽  
Symptomatic Cholelithiasis ◽  
Pain Duration ◽  
Comparative Trials

<p class="abstract">Symptomatic cholelithiasis (gallstone disease) is the most common biliary pathology that affects women predominantly around the world. Earlier open cholecystectomy was the gold standard of treatment of this disease before introduction of laparoscopic cholecystectomy. The aim of this study is to systematically review the most recent published data that compared laparoscopic with open cholecystectomy in symptomatic cholelithiasis in terms of operative and post-operative morbidity, mortality, operative time, length of hospital stay, and conversion rates. The Medline, Cochrane library, Embase, and PubMed databases were vigorously searched for trials that compared laparoscopic with open cholectstectomy in patients with symptomatic cholelithiasis, a systematic review of these comparative trials was performed. No mortality was detected in both groups; the conversion rate was 6.75%. The laparoscopic approach associated with significantly shorter hospital stay (2.31 versus 4.42 days, p value&gt;0.001), lower post-operative pain duration (30.5 versus 66.9 hours, p value&gt;0.001) and lower rate of post-operative wound infection (2.8% versus 10.5%, p value&gt;0.001). Regarding operative time it was significantly longer in laparoscopic approach (77.3 versus 67.1 min, p value&gt;0.001), there were no significant differences in the rates of bile duct injury (0.84% versus 0.25%, p value=0.08) and intra-operative bleeding (4.2% versus 3.5%, p value=0.81) between the two procedures. Post-operative wound infection and pain duration in addition to length of hospital stay in patients with symptomatic cholelithiasis were reduced with laparoscopic cholecystectomy. However, the laparoscopic approach associated with longer duration of surgery. No significant differences between the two procedures in the rates of bile duct injury and intra-operative bleeding.</p>

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 A randomized prospective comparative study of laparoscopic appendicectomy versus open appendicectomy

2017 ◽  
Vol 4 (9) ◽  
pp. 2987
Author(s):  
Rajbir Singh Bajwa ◽  
Navjot Brar
Keyword(s):  
Comparative Study ◽  
Laparoscopic Approach ◽  
Population Group ◽  
Laparoscopic Appendicectomy ◽  
Controlled Study ◽  
Laparoscopic Technique ◽  
Safe Procedure ◽  
Open Appendicectomy ◽  
Training Tool ◽  
Prospective Comparative Study

Background: Acute appendicitis is the most frequent cause of persisting progressive abdominal pain in all ages. However, there is no way to prevent the development of appendicitis, the only way to reduce the morbidity and to prevent the development of appendicitis, is to perform appendicectomy before perforation or gangrene has occurred. In this study, we have done a randomized, prospective comparative study of laparoscopic appendicectomy versus open appendicectomy in the Department of Surgery, Sri Guru Ramdas Hospital and Research Institute, Sri Amritsar from August 2014 to December 2016 a period of two years and four months.Methods: This prospective randomized controlled study was carried out in the department of General Surgery. The total population group included 144 patients with a mean age of 39 years (Age group between 18-60 years). Patients between 18 years and 60 years of age were candidates for randomization. The study was carried out as an open randomized single centre study.Results: In the present study patients were not blinded to the surgical technique employed but were equally informed to resume normal activity and work as soon as possible at their discretion. The results show that time to return to heavy work was significantly reduced by the laparoscopic approach. Less pain in the post-operative period was the major contributing factor. In the present study, laparoscopic appendicectomy was associated with improved cosmesis when compared with open appendicectomy (P <0.01).Conclusions: Laparoscopic appendicectomy is a safe procedure with lower morbidity it is also an excellent training tool in laparoscopic technique and with sufficient experience takes no longer than open appendicectomy.

scholarly journals Comparison of clinical outcomes of open, laparoscopic and single port appendicectomies

2013 ◽  
Vol 95 (7) ◽  
pp. 468-472 ◽  
Author(s):  
X Jiang ◽  
HB Meng ◽  
DL Zhou ◽  
WX Ding ◽  
LS Lu
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Operative Time ◽  
Single Port ◽  
Length Of Hospital Stay ◽  
Laparoscopic Appendicectomy ◽  
Suspected Appendicitis ◽  
Patient Demographics ◽  
Chinese Yuan

Introduction Appendicectomy is the most common surgical procedure performed in general surgery. This study aimed to compare the outcomes of open appendicectomy (OA), laparoscopic appendicectomy (LA) and single port laparoscopic appendicectomy (SPLA). Methods Fifty consecutive patients with suspected acute appendicitis were studied (OA: n=20, LA: n=20, SPLA: n=10). Clinical outcomes were compared between the three groups in terms of operative time, blood loss, postoperative complications, length of hospital stay and cost. Results Patient demographics were similar among groups (p>0.05). SPLA was characterised by longer operative time (88.1 minutes vs 35.6 minutes in OA and 33.4 minutes in LA) and higher costs (12.84 thousand Chinese yuan [RMB] vs 8.41 thousand RMB in LA and 4.99 thousand RMB in OA). OA was characterised by more blood loss (9.8ml vs 7.5ml in SPLA and 6.8ml in LA), longer hospital stay (7.5 days vs 3.5 days in LA and 3.4 days in SPLA) and lower costs. The total number of complications was higher for OA (n=2) than for LA and SPLA (n=0) although this was not statistically significant. Conclusions Where feasible, LA should be undertaken as the initial treatment of choice for most cases of suspected appendicitis.

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 Is the laparoscopic approach superior to open approach for treatment of acute appendicitis? A hospital based experience

2017 ◽  
Vol 4 (5) ◽  
pp. 1726
Author(s):  
Anil Reddy Pinate ◽  
Mohammad Fazelul Rahman Shoeb ◽  
Shiva Kumar C. R.
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Operative Time ◽  
Laparoscopic Group ◽  
Laparoscopic Appendicectomy ◽  
Open Group ◽  
Open Appendicectomy ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Laparoscopic appendicetomy remains controversial in Indian perspective. The objective was to compare the clinical outcome of open with laparoscopic appendicectomy.Methods: Prospectively collected data from 150 consecutive patients with acute appendicitis was studied. Patients undergoing surgery for acute appendicitis were alternately assigned into one of the two groups (Group-A patients underwent open appendicectomy and in Group B laparoscopic appendicectomy). The two groups were compared with respect to operative time, length of hospital stay, postoperative pain & wound complications.Results: The mean operative time in the open group was 84.40 minutes; for laparoscopic group, 95.20 minutes (p-0.001). Duration of paralytic ileus, tolerance to oral feeds, resumption of daily routine activity and ambulation of patients were started earlier in laparoscopic group than open group. Group A (OA) patients had pain at the mean of 2.66 days as compared group B (LA), in which patients had pain at the mean of 1.66 days.  Study also showed that the hospital stay for laparoscopic group was almost half of that for open group. Laparoscopic appendicectomy was safe as compared to open surgery in context to post-operative complications.Conclusions: Provided surgical experience and equipment are available, Laparoscopic appendicectomy is as safe and efficient than open appendicectomy.

scholarly journals Laparoscopic Versus Open Appendicectomy for Treatment of Acute Appendicitis

2019 ◽  
Vol 20 (1) ◽  
pp. 24-25
Author(s):  
Mohammad Ali ◽  
Kazi Lsrat Jahan
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Gold Standard ◽  
Operative Time ◽  
The Other ◽  
Laparoscopic Appendicectomy ◽  
Abdominal Abscess ◽  
Open Appendicectomy ◽  
Laparoscopic Skills ◽  
Operative Complications

Laparoscopic appendicectomy is not yet considered the "gold standard" in the treatment of acuteappendicitis because of its higher operative time, intra-abdominal abscess risk, and costscompared to open appendicectomy. On the other hand laparoscopic appendicectomy is associatedwith fewer post operative complications, shorter hospital stay, and nearly similar operative time,intra-abdominal abscess rate, and total costs, compared with open appendicectomy. With increasein the experience of the surgeon in laparoscopic skills pit falls will be much lower. Therefore, laparoscopicappendectomy can be recommended as preferred approach in acute appendicitis Journal of Surgical Sciences (2016) Vol. 20 (1) : 24-25

scholarly journals Laparoscopic versus open distal pancreatectomy: a single centre propensity score matching analysis

2021 ◽  
Author(s):  
Riccardo Casadei ◽  
Carlo Ingaldi ◽  
Claudio Ricci ◽  
Laura Alberici ◽  
Emilio De Raffele ◽  
...  
Keyword(s):  
Propensity Score ◽  
Hospital Stay ◽  
Distal Pancreatectomy ◽  
Pancreatic Neoplasms ◽  
Postoperative Morbidity ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Single Centre ◽  
Oncological Outcomes ◽  
Open Distal Pancreatectomy

AbstractThe laparoscopic approach is considered as standard practice in patients with body-tail pancreatic neoplasms. However, only a few randomized controlled trials (RCTs) and propensity score matching (PSM) studies have been performed. Thus, additional studies are needed to obtain more robust evidence. This is a single-centre propensity score-matched study including patients who underwent laparoscopic (LDP) and open distal pancreatectomy (ODP) with splenectomy for pancreatic neoplasms. Demographic, intra, postoperative and oncological data were collected. The primary endpoint was the length of hospital stay. The secondary endpoints included the assessment of the operative findings, postoperative outcomes, oncological outcomes (only in the subset of patients with pancreatic ductal adenocarcinoma-PDAC) and total costs. In total, 205 patients were analysed: 105 (51.2%) undergoing an open approach and 100 (48.8%) a laparoscopic approach. After PSM, two well-balanced groups of 75 patients were analysed and showed a shorter length of hospital stay (P = 0.001), a lower blood loss (P = 0.032), a reduced rate of postoperative morbidity (P < 0.001) and decreased total costs (P = 0.050) after LDP with respect to ODP. Regarding the subset of patients with PDAC, 22 patients were analysed: they showed a significant shorter length of hospital stay (P = 0.050) and a reduction in postoperative morbidity (P < 0.001) after LDP with respect to ODP. Oncological outcomes were similar. LDP showed lower hospital stay and postoperative morbidity rate than ODP both in the entire population and in patients affected by PDAC. Total costs were reduced only in the entire population. Oncological outcomes were comparable in PDAC patients.

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