Comparative Evaluation of Open and Laproscopic Method of Appendectomy in Acute Appendicitis

Background: There is definitely added advantage of laparoscopic operations. Most of the surgeons now prefer these minimally invasive proce- dures. Laparoscopy has become the number one choice of educated and affording patients. The aim of the study was to compare and evaluate the open and laproscopic method of appendectomy in acute appendicitis. Subjects and Methods: The subjects undergoing appendectomy were evaluated for age, sex, episode number, duration of pain before presentation in hospital, operative time, conversion rate, wound infection, post-operative intra-abdominal abscess formation, and stay in hospital. Results: It was found that average operative time in open surgery was 67.5 minutes and 104 minutes in laparoscopic surgery, with a conversion to open in about 20% of the cases. Oral feeding in the open group was around the 5th day while it was around 2nd day in the laparoscopic group. Average hospital stay was also low in the laparoscopic group, being only around 5 days in laparoscopic group and around 8 days in the open group. Overall complications were also low in the laparoscopic surgery group. Conclusion: It was noted that though conversion to open operation was definitely high but there were other advantages of laparoscopic surgery as well. Stay in the hospital, beginning of oral feeds, requirement of analgesics, wound infection, intra-abdominal abscess; pulmonary complications were less in laparoscopy group.

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Clinical outcome of appendectomy: laparoscopic vs open technique

International Surgery Journal ◽

10.18203/2349-2902.isj20215137 ◽

2021 ◽

Vol 9 (1) ◽

pp. 93

Author(s):

Jan M. Rather ◽

Sobia Manzoor ◽

Mubashir Shah

Keyword(s):

Clinical Outcome ◽

Acute Appendicitis ◽

Standard Care ◽

Operative Time ◽

Open Appendectomy ◽

Laparoscopic Group ◽

Open Group ◽

Complication Rates ◽

Open Technique ◽

Duration Of Hospital Stay

Background: Acute appendicitis is a common abdominal surgical emergency. Appendectomy has been proven to be the standard care for the treatment of acute appendicitis. Objective of the study was to compare laparoscopic and open appendectomy in terms of clinical outcome and complication rates.Methods: This was a single centric, retrospective study conducted at SKIMS, Soura from May 2018 to April 2021. Open and laparoscopic appendectomy patients were compared in terms of operative times, conversion rate, complication rates and duration of hospital stay.Results: Total 120 patients were included in this study with 40 in laparoscopic group while 80 patients in the open group. Increased operative time in laparoscopic group (p=0.033) and longer duration of hospital stay (p=0.021) with open group while as comparable complication rate in both procedures were observed. Higher rates of intra-abdominal collection in laparoscopic group as compared to open groupConclusions: Both laparoscopic and open appendectomy procedures can be performed routinely for acute appendicitis without the additional risks of complications.

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Complications after Laparoscopic Appendectomy for Complicated Appendicitis

Lietuvos chirurgija ◽

10.15388/lietchirur.2020.19.23 ◽

2020 ◽

Vol 19 (1-2) ◽

pp. 34-41

Author(s):

Andrej Nikolovski ◽

Shenol Tahir ◽

Dragoslav Mladenovikj

Keyword(s):

Postoperative Complications ◽

Wound Infection ◽

Laparoscopic Appendectomy ◽

Operative Time ◽

Open Appendectomy ◽

Laparoscopic Group ◽

Complicated Appendicitis ◽

Open Group ◽

Uncomplicated Appendicitis ◽

Low Incidence

Background. Laparoscopic appendectomy is established method in the treatment of complicated appendicitis. Certain advantages of the technique do not fulfill the expectations for its superiority over the open appendectomy as when it is used for uncomplicated appendicitis. This is generally caused because of the high variety of postoperative complications reported in different series for complicated appendicitis. Material and methods. This prospective interventional clinical study analyzes 61 patients operated with laparoscopic and open appendectomy due to complicated appendicitis, with an end point of comparing the intra and postoperative complications in both groups. Results. Conversion in open appendectomy was forced in one patient (1.63%). The operative time was significantly shorter in the laparoscopic group (p = 0.048). Wound infection was significantly predominant in the open group (p = 0.045). Postoperative intraabdominal abscess occurred in one patient in the laparoscopic group (p = 0.52). The overall morbidity was 26.2% (7 patients in the laparoscopic, and 9 in the open group; p = 0.59). Length of stay was significantly shorter in the laparoscopic group (p = 0.00001). Conclusion. Certain significant advantages of the laparoscopic appendectomy as low incidence of wound infection, short hospitalization, less postoperative pain and faster socialization makes the laparoscopy up to date method in the treatment of complicated appendicitis.

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

International Surgery Journal ◽

10.18203/2349-2902.isj20171629 ◽

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.

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Aspiration versus peritoneal lavage in appendicitis: a meta-analysis

World Journal of Emergency Surgery ◽

10.1186/s13017-021-00391-y ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Gloria Burini ◽

Maria Chiara Cianci ◽

Marco Coccetta ◽

Alessandro Spizzirri ◽

Salomone Di Saverio ◽

...

Keyword(s):

Systematic Review ◽

Wound Infection ◽

Operative Time ◽

Peritoneal Lavage ◽

Meta Analysis ◽

Statistical Significance ◽

Laparoscopic Group ◽

Reoperation Rate ◽

Abdominal Abscess ◽

Surgical Emergencies

Abstract Background Acute appendicitis is one of the most frequent abdominal surgical emergencies. Intra-abdominal abscess is a frequent post-operative complication. The aim of this meta-analysis was to compare peritoneal irrigation and suction versus suction only when performing appendectomy for complicated appendicitis. Methods According to PRISMA guidelines, a systematic review was conducted and registered into the Prospero register (CRD42020186848). The risk of bias was defined to be from low to moderate. Results Seventeen studies (9 RCTs and 8 CCTs) were selected, including 5315 patients. There was no statistical significance in post-operative intra-abdominal abscess in open (RR 1.27, 95% CI 0.75–2.15; I2 = 74%) and laparoscopic group (RR 1.51, 95% CI 0.73–3.13; I2 = 83%). No statistical significance in reoperation rate in open (RR 1.27, 95% CI 0.04–2.49; I2 = 18%) and laparoscopic group (RR 1.42, 95% CI 0.64–2.49; I2 = 18%). In both open and laparoscopic groups, operative time was lower in the suction group (RR 7.13, 95% CI 3.14–11.12); no statistical significance was found for hospital stay (MD − 0.39, 95% CI − 1.07 to 0.30; I2 = 91%) and the rate of wound infection (MD 1.16, 95% CI 0.56–2.38; I2 = 71%). Conclusions This systematic review has failed to demonstrate the statistical superiority of employing intra-operative peritoneal irrigation and suction over suction-only to reduce the rate of post-operative complications after appendectomy, but all the articles report clinical superiority in terms of post-operative abscess, wound infection and operative times in suction-only group.

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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 of Laparoscopic and Open Emergency Surgery for Colorectal Perforation: A Retrospective Study

10.21203/rs.3.rs-1058924/v1 ◽

2021 ◽

Author(s):

Kensuke Kudou ◽

Tetsuya Kusumoto ◽

Sho Nambara ◽

Yasuo Tsuda ◽

Eiji Kusumoto ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Blood Loss ◽

Hospital Stay ◽

Emergency Surgery ◽

Laparoscopic Approach ◽

Laparoscopic Group ◽

Open Group ◽

Emergency Setting ◽

Intraoperative Blood Loss ◽

Colorectal Perforation

Abstract Background This study aimed to clarify the safety and efficacy of laparoscopic surgery for colorectal perforation by comparing the clinical outcomes between laparoscopic and open emergency surgery for colorectal perforation. Methods We retrospectively reviewed the data of 100 patients who underwent surgery for colorectal perforation. The patients were categorized into two groups: the open group included patients who underwent laparotomy, and the laparoscopic group included those who underwent laparoscopic surgery. Clinical and operative characteristics and postoperative outcomes were evaluated. Results The open and laparoscopic groups included 58 and 42 patients, respectively. More than half of the patients in both groups developed perforation in the sigmoid colon (open, 55.2%; laparoscopic, 59.5%). The most common cause of perforation was diverticulum, followed by colorectal cancer. The mean intraoperative blood loss tended to be lower in the laparoscopic group than in the open group (78.8 mL versus 160.1 mL; P=0.0756). Hospital stay tended to be shorter in the laparoscopic group than in the open group (42.5 versus 55.7 days; P=0.0965). There were no significant differences in either the short- or long-term outcomes between the two groups. Univariate and multivariate analyses showed that the choice of surgical approach (open versus laparoscopic) did not affect overall survival in patients with colorectal perforation. Conclusions The laparoscopic approach for colorectal perforation in an emergency setting is a safe procedure compared with the open approach. The laparoscopic approach was associated with a decrease in intraoperative blood loss and a shorter length of hospital stay.

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A COMPARATIVE ANALYSIS OF CLINICALAND PATHOLOGICAL OUTCOME FOLLOWING LAPAROSCOPIC VERSUS OPEN RESECTION IN COLORECTAL CANCER IN A TERTIARY CARE CENTRE IN EASTERN INDIA

10.36106/ijsr/3703547 ◽

2021 ◽

pp. 12-17

Author(s):

Rishin Dutta ◽

Makhan Lal Saha ◽

Chhanda Datta ◽

Diptendra Kumar Sarkar ◽

Soumen Das ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Open Surgery ◽

Tertiary Care ◽

Operating Time ◽

Laparoscopic Group ◽

Open Group ◽

Tertiary Care Centre ◽

Colorectal Cancer Surgery ◽

Female Ratio

Background: Colorectal cancer surgery has undergone a continuous evolution of techniques and technologies with the aim of improving oncological outcome and the quality of life. Methods: Using a computer-based randomization patients were divided into two groups. One group underwent laparoscopic surgery (n=20) while the other open surgery (n=20). Results: rd th th th Most common age group affected was in the 3 and 4 decade of life followed by the 5 and 6 decade with a male: female ratio of 1.1:1. The mean operating time was longer in laparoscopic group (218.0±28 mins vs. 191±25 mins in open group) but the intra-operative blood loss was signicantly less in the laparoscopic group (46.2±8 ml) than the open group (107±11 ml). Post-operative complications like wound infection were signicantly lower in the laparoscopic group (zero patient vs. six patients in open group). Conclusion: With proper training and expertise laparoscopic surgery is advantageous over open surgery in colorectal malignancies.

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Open versus Laparoscopic Inguinal Hernioplasty - Outcome Correlation

Journal of Shaheed Suhrawardy Medical College ◽

10.3329/jssmc.v8i1.31496 ◽

2017 ◽

Vol 8 (1) ◽

pp. 3-7

Author(s):

Akhter Ahmed ◽

Salma Yesmin Chowdhury ◽

Md Mustafizur Rahman ◽

Farhana Shimu ◽

Shaon Shahriar ◽

...

Keyword(s):

Laparoscopic Surgery ◽

Confidence Interval ◽

Mesh Repair ◽

Open Surgery ◽

Laparoscopic Group ◽

Open Group ◽

Laparoscopic Technique ◽

Percent Confidence Interval ◽

Surgery Group ◽

Inguinal Hernias

Background: Repair of inguinal hernias in men is a common surgical procedure, but the most effective surgical technique is still in debate.Methods: We randomly assigned men with inguinal hernias at Mitford Hospital surgery, ward to either open mesh or laparoscopic mesh repair. The primary aim was to detect recurrence of hernias in both groups at 6 month. Secondary aims were to detect complications and patient compliance.Results: of the 70 patients who were randomly assigned to one of the two procedures, 62 underwent operation; 6 month follow-up was completed in 55 (78.6%). Recurrences were only one in the laparoscopic group (3.6%) and 1 in the open group (3.7%). The rate of complications was lower in the laparoscopic-surgery group than in the open-surgery group (17.6% vs. 27%). The laparoscopic- surgery group had less pain initially than the open-surgery group on the day of surgery (difference in mean score on a visual-analogue scale, 10.2 mm; 95 percent confidence interval, 4.8 to 15.6) and at two weeks (6.1 mm; 95 percent confidence interval, 1.7 to 10.5) and returned to normal activities earlier (adjusted hazard ratio for a shorter time to return to normal activities, 1.2; 95% confidence interval, 1.1 to 1.3). Hospital stay was shorter in laparoscopic group (2.6 days vs 3.2 days). Patients satisfaction with surgery was 95% in the laparoscopic group and 87% in open group. Nenety six laparoscopic and 87% of open surgery patients perceived that they were healthy after surgery. Total treatment cost was more in laparoscopic group.Conclusions: The laparoscopic technique is superior to the open technique for mesh repair of primary hernias.J Shaheed Suhrawardy Med Coll, June 2016, Vol.8(1); 3-7

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The Safety and Effectiveness of Laparoscopic Pyloromyotomy Using 3-mm Electrocautery Hook versus Open Surgery for Treatment of Hypertrophic Pyloric Stenosis in Infants

Children ◽

10.3390/children8080701 ◽

2021 ◽

Vol 8 (8) ◽

pp. 701

Author(s):

Zenon Pogorelić ◽

Ana Zelić ◽

Miro Jukić ◽

Carlos Martin Llorente Muñoz

Keyword(s):

Hospital Stay ◽

Wound Infection ◽

Pyloric Stenosis ◽

Hypertrophic Pyloric Stenosis ◽

Oral Intake ◽

Laparoscopic Group ◽

Open Group ◽

Open Approach ◽

Duration Of Surgery ◽

Laparoscopic Pyloromyotomy

Background: The standard of treatment for infants with hypertrophic pyloric stenosis is still pyloromyotomy. Recently, in most of the pediatric surgery centers laparoscopic pyloromyotomy has become popular. The aim of the present study is to compare the outcomes of treatment in infants with hypertrophic pyloric stenosis between traditional open approach and laparoscopic pyloromyotomy using 3-mm electrocautery hook. Methods: A total of 125 infants, 104 (83.2%) males, with median age 33 (interquartile range, IQR 24, 40) days, who underwent pyloromyotomy because of hypertrophic pyloric stenosis, between 2005 and 2021, were included in the retrospective study. Of that number 61 (48.8%) infants were allocated to the open group and 64 (51.2%) to the laparoscopic group. The groups were compared in regards to time to oral intake, duration of surgery, the type and rate of complications, rate of reoperations, frequency of vomiting after surgery, and the length of hospital stay. Results: No differences were found with regards to baseline characteristics between two investigated groups. Laparoscopic approach was associated with significantly better outcomes compared to open approach: shorter duration of surgery (35 min (IQR 30, 45) vs. 45 min (40, 57.5); p = 0.00008), shorter time to oral intake (6 h (IQR 4, 8) vs. 22 h (13.5, 24); p < 0.00001), lower frequency of postoperative vomiting (n = 10 (15.6%) vs. n = 19 (31.1%)), and shorter length of postoperative hospital stay (3 days (IQR 2, 3) vs. 6 days (4.5, 8); p < 0.00001). In regards to complications and reoperation rates, both were lower in the laparoscopic pyloromyotomy group but the differences were not statistically significant (p = 0.157 and p = 0.113, respectively). The most common complication in both groups was mucosal perforation (open group, n = 3 (4.9%); laparoscopic group, n = 2 (3.1%)) followed by wound infection in open group, n = 3 (4.9%). No cases of wound infection were recorded in the laparoscopic group. Conclusion: Open and laparoscopic pyloromyotomy are equally safe and effective in treatment of hypertrophic pyloric stenosis. Laparoscopic technique is associated with faster recovery, shorter duration of surgery and shorter duration of hospital stay.

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Comparison of Therapeutic Effects of Laparoscopic and Open Operation for Congenital Choledochal Cysts in Adults

Gastroenterology Research and Practice ◽

10.1155/2014/670260 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 8

Author(s):

Yuan Liu ◽

Xu Yao ◽

Shuqiang Li ◽

Wenhan Liu ◽

Lei Liu ◽

...

Keyword(s):

Blood Loss ◽

Operative Time ◽

Laparoscopic Group ◽

Adult Patients ◽

Open Group ◽

Therapeutic Effects ◽

Intraoperative Blood Loss ◽

Choledochal Cysts ◽

Cyst Excision ◽

Postoperative Stay

Background. Laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy for treating congenital choledochal cysts (CCCs) have proved to be efficacious in children. Its safety and efficacy in adult patients remain unknown. The purpose of this study was to determine whether the laparoscopic procedure was feasible and safe in adult patients.Methods. We reviewed 35 patients who underwent laparoscopic operation (laparoscopic group) and 39 patients who underwent an open procedure (open group). The operative time, intraoperative blood loss, time until bowel motion recovery, duration of drainage, postoperative stay, time until resumption of diet, postoperative complications, and perioperative laboratory values were recorded and analyzed in both groups.Results. The operative time was longer in the laparoscopic group and decreased significantly with accumulating surgical experience (P<0.01). The mean intraoperative blood loss was significantly lower in the laparoscopic group (P<0.01). The time until bowel peristalsis recovery, time until resumption of diet, abdominal drainage, and postoperative stay were significantly shorter in the laparoscopic group (P<0.01). The postoperative complication rate was not higher in the laparoscopic group than in the open group (P>0.05).Conclusions. Laparoscopic cyst excision and hepaticojejunostomy are a feasible, effective, and safe method for treating CCCs in adult patients.

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