scholarly journals Impact of Single-port Laparoscopic Approach on Postoperative Pain and Cosmesis for Acute Appendicitis: A Comparison with Multi-port Laparoscopic Approach

2021 ◽  
Author(s):  
Kyeong Eui Kim ◽  
In Soo Cho ◽  
Sung Uk Bae ◽  
Woon Kyung Jeong ◽  
Hyung Jin Kim ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Laboratory Findings ◽  
Abdominal Emergency ◽  
Scar Assessment ◽  
Cosmetic Outcomes

Abstract Background: Acute appendicitis is the most common surgical abdominal emergency. Single-port laparoscopic appendectomy (SPLA) has been suggested potential advantages including less postoperative pain and better cosmesis. The aim of this study was to compare the postoperative pain and cosmetic outcomes between SPLA and multi-port laparoscopic appendectomy (MPLA) for acute appendicitis.Materials and methods: The study included 47 patients who underwent SPLA and 51 patients who underwent MPLA for acute appendicitis between August 2014 and November 2017. The patient scar assessment questionnaire (PSAQ) was used to assess cosmetic outcomes. Results: MPLA involved a longer median operative time than MPLA (60 vs. 47.5 minutes, p=0.02). There were no apparent differences in the time before diet tolerance, length of hospital stay, inflammatory laboratory findings including C-reactive protein and white blood cell count, and postoperative complication rate. SPLA patients had a smaller total incision length (2.0 vs. 2.5 cm, p<0.001) and the total number of analgesics used on postoperative day 0 in the SPLA group was significantly lower than that of the MPLA group (1 vs. 1, p=0.011). The PSAQ scores showed that the SPLA group had a better overall outcome than the MPLA group with respect to total score (48 vs. 55; p = 0.026), appearance (15 vs. 18; p = 0.002) and consciousness (8 vs. 10; p = 0.005), but not in the satisfaction with appearance and symptoms subscales.Conclusion: SPLA is safe and feasible and provides better cosmetic outcomes and less analgesic requirements on the day of surgery compared to MPLA.

scholarly journals Impact of single-port laparoscopic approach on postoperative pain and cosmesis for acute appendicitis: a comparison with multi-port laparoscopic approach

2021 ◽  
Author(s):  
Kyeong Eui Kim ◽  
In Soo Cho ◽  
Sung Uk Bae ◽  
Woon Kyung Jeong ◽  
Hyung Jin Kim ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Laboratory Findings ◽  
Abdominal Emergency ◽  
Scar Assessment ◽  
Cosmetic Outcomes

Abstract Background: Acute appendicitis is the most common surgical abdominal emergency. Single-port laparoscopic appendectomy (SPLA) has been suggested potential advantages including less postoperative pain and better cosmesis. The aim of this study was to compare the postoperative pain and cosmetic outcomes between SPLA and multi-port laparoscopic appendectomy (MPLA) for acute appendicitis.Materials and methods: The study included 47 patients who underwent SPLA and 51 patients who underwent MPLA for acute appendicitis between August 2014 and November 2017. The patient scar assessment questionnaire (PSAQ) was used to assess cosmetic outcomes. Results: MPLA involved a longer median operative time than MPLA (60 vs. 47.5 minutes, p=0.02). There were no apparent differences in the time before diet tolerance, length of hospital stay, inflammatory laboratory findings including C-reactive protein and white blood cell count, and postoperative complication rate. SPLA patients had a smaller total incision length (2.0 vs. 2.5 cm, p<0.001) and the total number of analgesics used on postoperative day 0 in the SPLA group was significantly lower than that of the MPLA group (1 vs. 1, p=0.011). The PSAQ scores showed that the SPLA group had a better overall outcome than the MPLA group with respect to total score (48 vs. 55; p = 0.026), appearance (15 vs. 18; p = 0.002) and consciousness (8 vs. 10; p = 0.005), but not in the satisfaction with appearance and symptoms subscales.Conclusion: SPLA is safe and feasible and provides better cosmetic outcomes and less analgesic requirements on the day of surgery compared to MPLA.

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 Single site multiport umbilical laparoscopic appendicectomy versus conventional multiport laparoscopic appendicectomy in acute settings

2014 ◽  
Vol 96 (6) ◽  
pp. 452-457 ◽  
Author(s):  
PA Jategaonkar ◽  
SP Yadav
Keyword(s):  
Statistical Significance ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Single Site ◽  
Laparoscopic Appendicectomy ◽  
Acute Setting ◽  
Pain Scores ◽  
Cosmetic Outcomes ◽  
The Mean

Introduction Although conventional multiport laparoscopic appendicectomy (CMLA) is preferred for managing acute appendicitis, the recently developed transumbilical laparoscopic approach is rapidly gaining popularity. However, its wide dissemination seems restricted by technical/technological issues. In this regard, a newly developed method of single site multiport umbilical laparoscopic appendicectomy (SMULA) was compared prospectively with CMLA to assess the former’s efficacy and the technical advantages in acute scenarios. Methods Overall, 430 patients were studied: 212 in the SMULA group and 218 in the CMLA group. The same surgeon performed all the procedures using routine laparoscopic instruments. The SMULA technique entailed three ports inserted directly at the umbilical mound through three distinct strategically placed mini-incisions without raising the umbilical flap. The CMLA involved the traditional three-port technique. Results Both groups were comparable in terms of demographic criteria, indications for surgery, intraoperative blood loss, time to ambulation, length of hospital stay and umbilical morbidity. Although the mean operative time was marginally longer in the SMULA group (43.35 minutes, standard deviation [SD]: 21.16 minutes) than in the CMLA group (42.28 minutes, SD: 21.41 minutes), this did not reach statistical significance. Conversely, the mean pain scores on day 0 and the cosmetic outcomes differed significantly and favoured the SMULA technique. None of the patients developed port site hernias over the follow-up period (mean 2.9 years). Conclusions The favourable outcomes for the SMULA technique are likely to be due to the three small segregated incisions at one place and better trocar ergonomics. The SMULA technique is safe in an acute setting and may be considered of value among the options for transumbilical appendicectomy.

LAPAROSCOPIC APPENDECTOMY BECOMES THE METHOD OF CHOICE IN THE TREATMENT OF ACUTE APPENDICITIS

2008 ◽  
Vol 37 (2) ◽  
pp. 143-146
Author(s):  
Samir Delibegovic ◽  
Ervin Matovic
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Usual Method ◽  
Open Approach ◽  
Frequent Complication ◽  
Medical Centers ◽  
Duration Of Operation ◽  
Methods Of Treatment

Introduction: Laparoscopic appendectomy becomes a usual method in the treatment of acute appendicitis, although its advantage over open appendectomy has been proven. In Bosnia and Herzegovina, a few medical centers are introducing laparoscopic appendectomy as a method of treatment of acute appendicitis. In this study we want to compare different methods of treatment of acute appendicitis. Patients and Methods: During 20 months we have analyzed 498 patients operated due to acute appendicitis. We followed the duration of operation, total hospitalization stay, complications of surgical procedure and reasons of conversion in patients operated by laparoscopic approach. Results: The duration of operation was 96 minutes in the group operated by open approach and 107 minutes in the group operated by laparoscopic approach. Total hospitalization stay was 3.9. days in the group operated by open approach and 2.3. days in the group operated by laparoscopic approach. The most frequent complication in the group operated by open approach was infection of the operative wound (56/452) and ileus (5/452), and in the group operated by laparosocopic approach ileus (1/46) was the most frequent complication. Conclusion: The patients operated by laparoscopic approach have fewer risk of wound infection, and the hospital stay is shorter. With the increase of surgeon’s experience this method of treatment of acute appendicitis will become a method of choice.

scholarly journals Laparoscopic appendectomy for acute appendicitis: an observational study from a peripheral hospital with limited facilities in Kashmir, India

2020 ◽  
Vol 7 (3) ◽  
pp. 717
Author(s):  
Hakeem Vaqar Ahmed ◽  
Majid Mushtaque
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Low Cost ◽  
Laparoscopic Approach ◽  
Suture Materials ◽  
Conversion To Open Surgery ◽  
Peripheral Hospital ◽  
Operative Complications ◽  
The Mean ◽  
Level Hospital

Background: Appendectomy is one of the most commonly performed procedures in abdominal surgery and the laparoscopic approach is gradually replacing the conventional laparotomy for acute appendicitis.Methods: A total of 108 patients with acute appendicitis who underwent laparoscopic appendectomy at JLNM Hospital Srinagar over a period of five years were evaluated in terms of feasibility and safety of the procedure at the District level hospital. It was an observational study.Results: The age of the patient ranged between 16 and 43 years, with 68 males and 40 females. Most (76.85%) of the patients had un-ruptured inflamed appendix. The mean operative time was 43 minutes with no intra-operative complications. Two patients required conversion to open surgery. Mean duration of hospital stay was 1.7 days. Eight patients had post-operative complications which were managed conservatively.Conclusions: Laparoscopic appendectomy is safe and feasible in expert hands, and can be done using low cost, readily available basic laparoscopic instruments and suture materials at hospitals with limited facilities.

scholarly journals Is the laparoscopic approach a safe choice for the management of acute appendicitis in pregnant women? A meta-analysis of observational studies

2019 ◽  
Vol 101 (4) ◽  
pp. 235-248 ◽  
Author(s):  
M Frountzas ◽  
C Nikolaou ◽  
K Stergios ◽  
K Kontzoglou ◽  
K Toutouzas ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Acute Appendicitis ◽  
Pregnant Women ◽  
Laparoscopic Appendectomy ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Open Appendectomy ◽  
Fetal Loss ◽  
Laparoscopic Approach ◽  
Increased Risk

IntroductionAcute appendicitis is a common and serious situation during pregnancy, because of the increased risk of fetal loss and perforation in the third trimester, as well as a diagnostic difficulty. During recent years laparoscopic approach has been introduced to clinical practice with encouraging results. The purpose of this meta-analysis is to compare the surgical and obstetrical outcomes between laparoscopic and open appendectomy during pregnancy.Materials and methodsMEDLINE, SCOPUS, Clinicaltrials.gov, CENTRAL and Google Scholar were searched for studies reporting on postoperative outcomes between laparoscopic and open appendectomy during pregnancy. The random effects model (DerSimonian–Laird) was used to calculate pooled effect estimates when high heterogeneity was encountered, otherwise the fixed-effects (Mantel–Haenszel) model was implemented.ResultsTwenty-one studies that enrolled 6276 pregnant women are included in the present meta-analysis. Of these women, 1963 underwent laparoscopic appendectomy and 4313 underwent an open appendectomy. Women who underwent laparoscopic appendectomy demonstrated an increase in fetal loss risk, while neonates of women that underwent open appendectomy presented decreased Apgar score at five minutes after birth. All the rest outcomes were similar between the two groups. The time that each study took place seemed to affect the comparison of birth weight and postoperative hospital stay between the two groups.ConclusionLaparoscopic appendectomy seems to be a relatively safe therapeutic option in pregnancy when it is indicated. Thus, it should be implemented in clinical practice, always considering the experience of the surgeon in such procedures. Nevertheless, the need of new studies to enhance this statement remains crucial.

Treatment of Acute Appendicitis in Geriatric Patients – Literature Review

2016 ◽  
Vol 88 (3) ◽  
Author(s):  
Anna Kot ◽  
Jakub Kenig ◽  
Piotr Wałęga
Keyword(s):  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Laparoscopic Appendectomy ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Independent Method ◽  
Number Of Patients ◽  
Pubmed Database ◽  
American Society

AbstractDemographic changes associated with the aging population mean that surgeons increasingly have contact and make decisions about treating patients from the oldest age groups.The aim of the study was to review the literature concerning the treatment of acute appendicitis in patients over the age of 60 years old.Material and methods. A review of the literature published in the years 2000-2015 has been carried out using the PubMed database. The initial number of results corresponding to the query in English, „appendicitis (MeSH) AND elderly (MeSH)” was 260. Selection based on the titles, abstracts, and eventually whole articles, ultimately resulted in 11 papers concerning the treatment of appendicitis in patients above 60 years of age.Results. Nine papers were retrospective and 2 were prospective. In total, the studies included 82,852 patients. Laparoscopic appendectomy was associated with a lower mortality rate, a smaller number of postoperative complications and a shorter length of hospital stay, which led to it being recommended by most authors. Four of the ten papers demonstrated that the patients who were qualified for laparoscopic surgery had less comorbidity and were in a lower ASA (American Society of Anaesthesiology) category. Antibiotic therapy as an independent method was assessed in one study in a group of elderly people, on a selected group of 26 patients, and its effectiveness was shown to be 70%. Most studies, however, are highly heterogeneous which significantly hindered comparisons.Conclusions. Currently, laparoscopic appendectomy seems to be the treatment of choice in the elderly with acute appendicitis. Antibiotic therapy, as an independent method of treatment of acute appendicitis, cannot currently be recommended. However, further, prospective, and better-designed studies are needed, involving a larger number of patients, and primarily dedicated to the elderly.

scholarly journals Retrospective analysis of laparoscopic versus open appendectomy for the treatment of acute appendicitis

2020 ◽  
Vol 7 (12) ◽  
pp. 4045
Author(s):  
Ritvik Resutra ◽  
Haroon Salaria ◽  
Rajive Gupta
Keyword(s):  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
Routine Activity ◽  
Laparoscopic Technique ◽  
Time Duration ◽  
Jammu And Kashmir ◽  
Post Operative Pain ◽  
General Surgeons

Background: Acute appendicitis is one of the most commonly encountered emergency by the general surgeons and appendectomy is the most common surgery performed in the world. Although open appendectomy is preferred by many surgeons, yet the laparoscopic approach is gradually replacing open surgery for treatment of acute appendicitis.Methods: A total of 400 patients of acute appendicitis were operated, 200 by laparoscopic appendectomy and 200 by open method by a single surgeon at various private hospitals in Jammu (Jammu and Kashmir), India over a period of three years from July 2017 to July 2020. The two groups were compared with respect to operative time, duration of hospital stay, post-operative pain, complication rate and time taken to resume routine activity and cosmetic satisfaction of the patients.Results: Results were found to be better with the laparoscopic technique. There was significantly less pain in the postoperative period with faster recovery, early resumption to work, reduced postoperative complications and better cosmetic satisfaction of the patients operated by the laparoscopic appendectomy technique as compared to open surgery.Conclusions: Laparoscopic appendectomy is safe and feasible technique in expert hands, for treatment of acute appendicitis with results comparable to the open appendectomy, with no obvious increase in complications and is definitely a procedure of choice for the management of acute appendicitis.

scholarly journals Comparison of Laparoscopic versus Open Appendicectomy

2015 ◽  
Vol 10 (2) ◽  
pp. 75-79
Author(s):  
SM Shahadat Hossain ◽  
Farhana Israt Jahan ◽  
Munshi M Mujibur Rahman ◽  
Md Abdus Samad Al Azad ◽  
Md Shahinur Rahman ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Acute Appendicitis ◽  
Hospital Stay ◽  
Operating Time ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Armed Forces ◽  
P Value ◽  
Surgical Trauma ◽  
Open Approach

Introduction: The advent of laparoscopic surgery has dramatically changed the field of surgery. With improvements in the equipment and increasing clinical experience it is now possible to perform almost any kind of procedure under laparoscopic visualization. The idea of minimal surgical trauma, resulting in significantly shorter hospital stay, less postoperative pain, faster return to daily activities, and better cosmetic outcome have made laparoscopic surgery for acute appendicitis very attractive.Objective: The aim of the present study was to compare the laparoscopic approach and the conventional technique in the treatment of acute appendicitis.Method: This prospective randomized clinical trial was conducted at CMH, Savar Cantonment and Navy Hospital, BNS Patenga, Chittagong. A total of 86 patients who underwent appendicectomy during December 2009 to March 2011 were included in this study. A total of 40 patients had laparoscopic appendicectomy and 46 underwent open procedure. Clinical outcome measures were compared between the two groups with respect to several variables.Results: Among the study population, the operating time was shorter for the OA patients than for the LA patients (LA, 35 min vs. OA, 30 min; p value 0.33), which is not statistically significant. The differences in hospital stay of 4 days for the LA group and 8 days for the OA group and p value 0.01 which is statistically significant. Return to oral diet was same in both groups with no statistical difference LA, 20 h vs. OA, 22 h; return to work LA was 14 days vs. OA 18 days. Although the rate for overall complications was lower in the LA group 5% vs. 18% in OA; p value 0.001 which is statistically significant.Conclusion: The laparoscopic approach to appendicectomy in patients with acute appendicitis does offer a significant advantage over the open approach in terms of length of hospital stay, postoperative complications, or quality of life, which are considered as the major advantages of minimally invasive surgery.Journal of Armed Forces Medical College Bangladesh Vol.10(2) 2014

scholarly journals ANALYSIS AND EVALUATION OF ADVANTAGES FROM LAPAROSCOPIC APPENDECTOMY

2022 ◽  
Vol 28 (1) ◽  
pp. 4183-4185
Author(s):  
Konstantin Kostov ◽  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Laparoscopic Appendectomy ◽  
Laparoscopic Approach ◽  
Length Of Hospital Stay ◽  
Analysis And Evaluation ◽  
Early Return ◽  
Post Operative Pain ◽  
Male Patients ◽  
Concomitant Factors

Purpose: The aim of the study is to evaluate the advantages of laparoscopic appendectomy fromour clinical experience in UMHATEM "Pirogov" which resulted in reduced postoperative complications, pain, length of hospital stay, and early return to work. Material and Methods: Data from a study of a patient group in the Department of General, Visceral and Emergency Surgery of UMBALSM "H. I. Pirogov "for the six-month period (01.01.2019 до 01.07.2019) were collected.Eighty-one patients with acute appendicitis who underwent laparoscopic appendectomy were selected. Indicators characterizing basic clinical and pathological features (epidemiology, demography, degree of pathological impairment), surgical approach and its outcomes (postoperative complications, postoperative duration), influence of concomitant factors were studied. Results: The study included 81 patients. The majority of patients were women - 46 (56.79%), men- 35 (43.21%). The mean age of male patients was 31.4 years and for female-28.6 years respectively. Hospitalization times are usually short - most patients are given up to 72 hours (70- 86.42%). Only eleven patients (13.58%) had an extended hospital stay for observation and additional therapy. Conclusion: Laparoscopic appendectomy was verified as an optimal and safe surgical procedure. Laparoscopic approach reduces post-operative pain, shortens hospital stay, reduces complications, and thereby reducing treatment costs.

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