Comparison of the outcomes among patients undergoing emergency open appendectomies by senior and junior surgeons: A cross-sectional study.


  • Sara Malik Pakistan Railway Hospital, Rawalpindi.
  • Zulqarnain Asad Rawalpindi Medical University, Rawalpindi.
  • Raheel Ahmed UK
  • Ramlah Ghazanfor CMH Rawalpindi.
  • Hamza Waqar Bhatti Benazir Bhutto Shaheed Hospital, Rawalpindi.
  • Mehwish Changez UK.
  • Maham Tariq CMH Rawalpindi.
  • Jahangir Sarwar Khan Holy Family Hospital, Rawalpindi



Acute Appendicitis, Emergency or Operation Theater, Senior Resident or Junior Resident


Objective: To compare the senior and junior surgeons in terms of the outcome of the open appendectomies. Study Design: Comparative Cross Sectional study. Setting: Holy Family Hospital, Rawalpindi. Period: January 2019 to April 2019. Material & Methods: Patients of 16 years and above who underwent emergency open appendectomies for suspected appendicitis were included while elective appendectomies and those done for gynecological indications were excluded from the study. After informed consent, 65 appendectomies were included in the study. SPSS v23.0 was used for data entry and analysis. Frequencies, percentages, means and standard deviations were calculated. Chi-square, t-test and Kruskall-Wallis tests were applied to test the significance of the results. Results were then presented in the form of tables. Outcome variables of the study were duration of the symptoms, Alvorado score, WBCs count, duration of surgery, per-operative findings, post-operative antibiotic, home treatment prescription, post-operative hospital stay and complications. Results: Out of total 65 appendectomies, 35 (53.8%) were done by junior surgeons, out of which 16 (45.71%) were males. Out of 30 appendectomies done at the hands of senior surgeons, 16 (53.3%) were done by males. There was no significant difference between the senior and junior surgeons except for Alvorado score (higher mean score for senior surgeons), per-operative findings (more complicated appendicitis in case of senior surgeons) and post-operative hospital stay (prolonged for senior surgeons’ appendectomies), p values are <0.000, 0.001, and <0.000, respectively. Conclusion: This study concludes that junior surgeons can safely perform open appendectomies with no difference in the incidence of complications as compared to senior surgeons.

Author Biographies

Sara Malik, Pakistan Railway Hospital, Rawalpindi.

MD, FCPS (General Surgery), Senior Registrar Surgery, 

Zulqarnain Asad, Rawalpindi Medical University, Rawalpindi.

MBBS, Medical Officer, 

Raheel Ahmed, UK

MBBS, FCPS, Consultant General Surgeon, 

Ramlah Ghazanfor, CMH Rawalpindi.

MBBS, FCPS, Fellow Vascular Surgery, 

Hamza Waqar Bhatti, Benazir Bhutto Shaheed Hospital, Rawalpindi.

MBBS, Postgraduate Trainee General Surgery, 

Mehwish Changez, UK.

MBBS, FCPS, Fellow Vascular Surgery, 

Maham Tariq, CMH Rawalpindi.

MBBS, FCPS, Fellow Breast Surgery, 

Jahangir Sarwar Khan, Holy Family Hospital, Rawalpindi

MBBS, FRCS, FCPS, Diploma Medical Education, Professor Surgery,