A comparative study of open versus laparoscopic appendectomy in a tertiary care hospital

Jyotiranjan Pani; Binaya Mihir Kunar; Rakesh Mondal; Abhijit Samal; Jitendra Narayan Senapati

Volume : VII, Issue : XII, December - 2017

A comparative study of open versus laparoscopic appendectomy in a tertiary care hospital

Jyotiranjan Pani, Binaya Mihir Kunar, Rakesh Mondal, Abhijit Samal, Jitendra Narayan Senapati

Abstract :

Although laparoscopic surgery has been available for a long time and laparoscopic cholecystectomy has been performed universally, it is still not clear whether open appendectomy (OA) or laparoscopic appendectomy (LA) is the most appropriate surgical approach for appendectomy. This study is to compare results of open appendectomy with laparoscopic appendectomy in terms of following parameters: Operating time, post–operative pain, time until resumption of diet, rate of wound infection, duration of postoperative hospital stay. Methodology: the study was conducted in IMS & SUM Hospital, Bhubaneswar involving 60 patients who were diagnosed to have appendicitis and requiring surgical intervention. Patients were randomized to either OA group or LA group. Statistical analyses were performed using SSPS version 10.0. Results: After randomization, thirty patients each in LA group and OA group were analyzed. The mean age of patients undergoing LA and OA were 24.81 years and 24.98 years respectively. The mean duration of surgery in the laparoscopic group was 54.45 minutes compared to 42.74 minutes in the open group (p=0.042). Visual analog scale for pain in the postoperative period for laparoscopic group was 4.00 as compared to 5.53 in the open group (p<0.000). Mean number of doses of parenteral analgesics required in the postoperative period for laparoscopic group was 2.13 as compared to 3.81 in the open group (p<0.000). Oral feeds were resumed earlier in the laparoscopic group (12.77 hours) as compared to the open group (26.71 hours), p<0.000. Rate of wound infection was nil in the laparoscopic group as compared to 12.90 % in the open ix group (p=0.04). Duration of postoperative hospital stay was 1.13 days in the laparoscopic group as compared to 3.26 days in the open group (p<0.000). Conclusion: laparoscopic appendectomy was better than open appendectomy with respect to pain score, lesser use of parenteral analgesics, duration of postoperative hospital stay, earlier resumption of oral feeds and wound infection rate.