scholarly journals Laparoscopic Versusopen Appendectomy - Which One Is Better?

2019 ◽  
Vol 17 (1) ◽  
pp. 7-13
Author(s):  
Md Atiar Rahman ◽  
Md Shahadot Hossain Sheikh ◽  
Md Ibrahim Siddique ◽  
Md Shahidul Islam ◽  
AKM Ahsan Ullah ◽  
...  

Objective: Appendectomy, being the most common surgical procedure performed in general surgery, is still being performed by both open and laparoscopic methods due to a lack of consensus as to which is the most appropriate method. Because further trials are necessary and few such studies have been performed in developing countries, we decided to evaluate the outcomes of the 2 procedures to share our experience with others. Methods: Prospectively collected data from 618 consecutive patients with appendicitis were studied. These comprised of 340 patients who underwent conventional open appendectomy and 260 patients treated laparoscoplcally&18 were excluded because of protocol violations. The two groups were compared with respect to operative time, length of hospital stay, postoperative pain, return to normal work, complication rate and cost. Results: There were no statistical differences regarding patient characteristics between the two groups. Conversion to laparotomy was necessary in 5 patients (1.88%). Laparoscopic appendectomy was associated with a shorter hospital stay (1.5 d vs 2.5 d), lower incidence of wound infection (3.07% vs 8.29%,) &less analgesia requirement. The operative time was more (45.6 vs 24.5 min) and the cost of treatment was higher in the laparoscopic group. Conclusion: The laparoscopic technique is a safe and clinically beneficial operative procedure. It provides certain advantages over open appendectomy, ·including short hospital stay, decreased requirement .of postoperative analgesia, early food tolerance, and earlier return to normal activities, Where feasible, laparoscopy should be undertaken as the initial procedure of choice for most cases of appendicitis. Journal of Surgical Sciences (2013) Vol. 17 (1) : 7-13

2019 ◽  
Vol 6 (4) ◽  
pp. 1144
Author(s):  
P. Senthil Kumar ◽  
S. Edwin Kin’s Raj ◽  
Saranya Nagalingam

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).


2017 ◽  
Vol 4 (10) ◽  
pp. 3397
Author(s):  
Shivakumar T ◽  
Ved Prakash Ranjan ◽  
Yamuna V. S. ◽  
Karthik P.

Background: Open appendectomy is one of the most common surgeries done in an emergency operation theatre even after three decades of introduction of laparoscopic surgeries. The previous studies done on laparoscopic appendectomy produced conflicting recommendations, and the adequacy of sample sizes is generally unknown. We compared primary outcomes after laparoscopic and open appendectomy in a sample of predetermined statistical power.Methods: A pre-study power analysis suggested that 200 randomized patients would yield 80% power to show a mean decrease of 1.3 days hospitalization. One hundred ninety-eight patients with a preoperative diagnosis of acute appendicitis were randomized prospectively to laparoscopic or open appendectomy. The primary outcomes measured were duration of operative time, postoperative pain and analgesia, length of hospital stay and cosmetic advantages.Results: It was found that mean operation time was 33±5.8 minute and 37± 7.5 minute in OA and LA respectively. Duration of post-operative hospital stay was 1.2 days shorter in Laparoscopic group. LA required 1.1 shots of less analgesic than OA. Oral feeding was resumed 21 hours earlier following LA compared to OA. Laparoscpic appendectomy was safely performed in paediatric patient without any adverse effect. We also found that, in female patient, concurrent ovarian cysts, tubal pregnancy and endometriosis can be diagnosed and managed laparoscopically in the same sitting.Conclusions: Present study found that laparoscopic appendectomy is an effective and safe procedure irrespective of age and sex of the patient. LA has added advantage of early return of bowel movement, less post-op hospital stays and less requirement of narcotic analgesic.


2012 ◽  
Vol 19 (01) ◽  
pp. 001-005
Author(s):  
JAHANGIR SARWAR KHAN ◽  
UMAR FAROOQ ◽  
HAMID HASSAN

Objective: The objective of this study was to compare length of hospital stay, pain scores and the rate of wound infectionsbetween laparoscopic and open appendectomy. Design: Randomized Controlled trial. Place and Duration of study: This study wasconducted in surgical unit I Holy Family hospital, Rawalpindi from 1st June 2009 to 31st May 2010. Patients and methods: The patients weredivided into open and laparoscopy groups and their age, sex, time of discharge, pain scores and wound infection rates were compared andanalyzed. Results: Total of 160 patients were included in the study, 80 in each group. There were 58% male and 42% female patients. Mean agewas 22.78 years (±6.2).Post operative pain scores were significantly less in the laparoscopic group (p<0.05). The length of hospital stay in opengroup was 35.10 hrs (±5.4) hours and in the laparoscopic group was 38.70(4.8) hrs with a p value of 0.592.Wound infection was 0.037% in openand 0.025% in the laparoscopic group. Conclusions: Laparoscopic appendectomy is superior in terms of less morbidity and shorter postoperative hospital stay in the setting of an overworked tertiary care surgical floor of a Pakistani hospital.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
M. Carbonnel ◽  
H. Abbou ◽  
H. T. N’Guyen ◽  
S. Roy ◽  
G. Hamdi ◽  
...  

Objectives. A prospective study was carried out to compare vaginal hysterectomy (VH) and robotically assisted hysterectomy (RH) for benign gynecological disease.Materials and Methods. All patients who underwent hysterectomy from March 2010 to March 2012 for a benign disease were included. Patients’ demographics per and post surgery results were collected from medical files. A questionnaire was also conducted 2 months after surgery.Results. Sixty patients were included in the RH group and thirty four in the VH one. Operative time was significantly longer in the RH group ( versus  min; ). Blood loss and length of hospital stay were significantly reduced: versus  ml; , and versus days; , respectively. Less pain was reported at D1 and D2 by RH patients, and levels of analgesia were lower compared to those observed in the VH group. No differences were found regarding the rate of conversion to laparotomy, intra- or postoperative complications.Conclusion. Robotically assisted hysterectomy appears to reduce blood loss, postoperative pain, and length of hospital stay, but it is associated with longer operative time and higher cost. Specific indications for RH remain to be defined.


Author(s):  
Mohammed Miftah ◽  
Jumanh Attiah ◽  
Omar Alawaji ◽  
Faisal Alghamdi ◽  
Abdulaziz Alasmari ◽  
...  

Appendicitis is the most common cause for abdominal surgeries among all age groups worldwide. Significant research papers were published concerning the techniques through which appendectomy is done. Open appendectomy has been the gold standard treatment for acute appendicitis and has been known as a safe practice with relatively low rate of postoperative complications. However, in the last few decades, laparoscopic surgery has developed widely with the advent of minimal surgical invasion and is now more increasingly prevalent intervention. In this study, we aim to report on previous literature on laparoscopic and open appendectomies that were carried out in Saudi Arabia and compare the efficacy, safety and complications of performing laparoscopic and open appendectomies including mean operative time, mean hospital stay and prevalence of postoperative complications, mainly, wound infection and intra-abdominal infections. PubMed database and EBSCO Information Services were used for articles selection. All relevant articles to our review with the topics regarding the appendectomy procedures; both open, laparoscopic, and other articles have been used. We excluded other articles, which are not related to this field. The data will be extracted according to specific form in which it is going to be reviewed by the group members. The study found out that mean operative time was shorter in open procedures than laparoscopic one making it open appendectomy the faster intervention. Mean hospital stay was found to be significantly less in LA than OA patients. Indicated higher rate of intra-abdominal infections in the LA patients than OA ones, while wound infections are mainly present in OA cases in the reference studies.


2020 ◽  
pp. 1-7
Author(s):  
Zhenhua Gu ◽  
Yucheng Yang ◽  
Rui Ding ◽  
Meili Wang ◽  
Jianming Pu ◽  
...  

<b><i>Background:</i></b> Advances in micro-percutaneous nephrolithotomy (PCNL) for kidney stones have made it an alternative approach to the retrograde intrarenal surgery (RIRS) approach. Nevertheless, the superiority of micro-PCNL over RIRS is still under debate. The results are controversial. <b><i>Objectives:</i></b> The purpose of this study was to systematically evaluate the clinical results in patients presenting with kidney stones treated with micro-PCNL or RIRS. <b><i>Methods:</i></b> A literature search was done for electronic databases to identify researches that compared micro-PCNL and RIRS till December 2019. The clinical outcome included complications, stone-free rates (SFRs), hemoglobin reduction, length of hospital stay, and operative time. <b><i>Results:</i></b> Five articles were included in our study. The pooled results revealed no statistical difference in the rate of complications (OR = 0.99, 95% CI = 0.57–1.74, <i>p</i> = 0.99), length of hospital stay (MD = −0.29, 95% CI = −0.82 to 0.24, <i>p</i> = 0.28), and operative time (MD = −6.63, 95% CI = −27.34 to 14.08, <i>p</i> = 0.53) between the 2 groups. However, significant difference was present in hemoglobin reduction (MD = −0.43, 95% CI = −0.55 to 0.30, <i>p</i> &#x3c; 0.001) and the SFRs (OR = 0.59, 95% CI = 0.36–0.98, <i>p</i> = 0.04) when comparing RIRS with micro-PCNL. <b><i>Conclusions:</i></b> Compared with micro-PCNL to treat kidney stones, RIRS is associated with better stone clearance and bearing higher hemoglobin loss. As the advantages of both technologies have been shown in some fields, the continuation of well-designed clinical trials may be necessary.


2001 ◽  
Vol 15 (4) ◽  
pp. 281-287 ◽  
Author(s):  
Shawn S. Nasseri ◽  
Jan L. Kasperbauer ◽  
Scott E. Strome ◽  
Thomas V. McCaffrey ◽  
John L. Atkinson ◽  
...  

The endoscopic transnasal approach is an evolving technique for treating lesions in the sella turcica. Since this method was introduced at our institution 4 years ago, the majority of transsphenoidal procedures are performed with it. The records of all patients having endoscopic transnasal hypophysectomy at the Mayo Clinic during the last 4 years were reviewed retrospectively. The criteria analyzed were safety, functional and cosmetic outcome, and complications. During the 4-year period, the operative procedure was modified to improve operative exposure and safety. The results of our review showed a significant decrease in length of hospital stay, reduced operative time, reduced need for nasal packing, and elimination of a sublabial incision. The complication rate was equivalent to that reported for the traditional transseptal transsphenoidal approach. As the neurosurgeons at our institution gained experience with this approach, an increasing number of pituitary microadenomas were resected safely and successfully. In addition, because of the limited septal dissection, this approach is particularly helpful for revision operations. This approach also can be used for the full range of pituitary lesions and in conjunction with adjunctive techniques, including frontal craniotomy and -knife irradiation. Currently, the endoscopic transsphenoidal approach is the method preferred for surgically treating pituitary lesions in adults at our institution.


2018 ◽  
Vol 84 (6) ◽  
pp. 991-995 ◽  
Author(s):  
Shuai Leiyuan ◽  
Xu Jianli ◽  
Zhao Zhengzhong ◽  
Ji Guangyan ◽  
Zhu Dailiang

To compare the clinic outcomes of endoscopic stenting and laparoscopic gastrojejunostomy (LGJ) for patients with malignant gastric outlet obstruction (GOO). We retrospectively reviewed 63 patients with malignant GOO that underwent endoscopic stenting [Stent Group (SG), n = 29] or LGJ [Laparoscopic Group (LG), n = 34]. Then, we evaluated the medical effects, postoperative hospital stay, and hospitalization expenses in both groups. Compared to LG, SG has a shorter operation time [SG: (41.1 ± 9.3) minutes vs LG: (137.4 ± 21.7) minutes, P = 0.000], less intra-operative blood loss [(23.7 ± 9.0) mL vs (121.1 ± 24.3) mL, P = 0.000], relatively lower hospitalization expenses [(2272.7 ± 413.9) $ vs (5182.4 ± 517.3) $, P = 0.000]. Besides, the median intake time was significantly shorter in the SG than that in the LG [(0.9 ± 0.3) days vs (4.1 ± 0.6) days, P = 0.000]. However, there were no significant differences between SG with LG in surgical success rate (100 vs 100%, P = 1.000), length of hospital stay [(6.1 ± 3.3) days vs (10.9 ± 4.7) days, P = 0.422], recurrent obstructive rate (37.9 vs 26.5%, P = 0.949) and median survivals [(141.4 ± 81.4) days vs (122.7 ± 88.8) days, P = 0.879]. Endoscopic stenting and LGJ are both relatively safe and effective treatments for patients with malignant GOO. But we suggest that endoscopic stenting should be considered first in patients with malignant GOO because it has many advantages over LGJ.


2019 ◽  
Vol 26 (6) ◽  
pp. 744-752
Author(s):  
Hailun Zhan ◽  
Chunping Huang ◽  
Tengcheng Li ◽  
Fei Yang ◽  
Jiarong Cai ◽  
...  

Objectives. The warm ischemia time (WIT) is key to successful laparoscopic partial nephrectomy (LPN). The aim of this study was to perform a meta-analysis comparing the self-retaining barbed suture (SRBS) with a non-SRBS for parenchymal repair during LPN. Methods. A systematic search of PubMed, Scopus, and the Cochrane Library was performed up to March 2018. Inclusion criteria for this study were randomized controlled trials (RCTs) and observational comparative studies assessing the SRBS and non-SRBS for parenchymal repair during LPN. Outcomes of interest included WIT, complications, overall operative time, estimated blood loss, length of hospital stay, and change of renal function. Results. One RCT and 7 retrospective studies were identified, which included a total of 461 cases. Compared with the non-SRBS, use of the SRBS for parenchymal repair during LPN was associated with shorter WIT ( P < .00001), shorter overall operative time ( P < .00001), lower estimated blood loss ( P = .02), and better renal function preservation ( P = .001). There was no significant difference between the SRBS and non-SRBS with regard to complications ( P = .08) and length of hospital stay ( P = .25). Conclusions. The SRBS for parenchymal repair during LPN can significantly shorten the WIT and overall operative time, decrease blood loss, and preserve renal function.


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