APPENDECTOMY

COMPARISON OF OUTCOMES OF LAPAROSCOPIC VERSUS OPEN

Abstract

Objective: The aim of this study was to compare the outcomes and morbidities of laparoscopic appendicectomy (LA) and open appendicectomy (OA) in patients with acute appendicitis. Design: Interventional study. Setting: The study was conducted at Madina Teaching Hospital, University Medical & Dental College, Faisalabad. Period: From June 2007 to August 2009. Materials and Methods: The study group consisted of two hundred patients suffering from acute appendicitis. One hundred patients underwent LA and one hundred patients underwent OA. Comparison was based on operating time, complications, requirements for postoperative analgesia, time until resumption to regular diet, hospital stay, and return to full activity in days. Comparisons were made between continuous variables using Student’s t test of the means and were made between proportions using Fischer’s exact or chi-square testing where appropriate. Statistical significance was taken to be a p value of .05 or less. Results: Of the hundred patients, five patients (5%) had the procedure converted to open surgery. The rate of infection was significantly lower in patients undergoing LA. The median length of stay was significantly shorter after LA (2 days after LA, 5 days after OA, P < 0.05) than after OA. The operating time was shorter {OA: 25 min (median), LA: 30 min (median), P > .05} in patients undergoing open appendicectomy compared to laparoscopic appendicectomy. Conclusion: LA is associated with increased clinical comfort in terms of fewer wound infections, faster recovery, earlier return to work and improved cosmesis.