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Comparative Studies | Surgery | India | Volume 13 Issue 12, December 2024 | Popularity: 5.6 / 10

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A Prospective Clinical Comparative Study of Clinical Outcome of Laparoscopic vs Open Appendicectomy in Tertiary Healthcare Center

Dr. Afaf Amla, Dr. S. Nisale, Dr. M. Chawada, Dr. G. Swami, Dr S. Jadhav

Abstract: Objective: To evaluate the prospective clinical comparative study of clinical outcomes of laparoscopic vs open appendicectomy. Methods: We conducted a prospective analysis of 200 acute appendicitis cases admitted to our institution. Among these, 100 (50%) underwent laparoscopic appendicectomy and 100 (50%) underwent open appendicectomy. Clinical outcomes were compared between the 2 groups in relation to operative time, analgesia used, length of hospital stay, return to work, resumption of a regular diet, postoperative complications, cosmoses and conversion rate. Results: The mean age for laparoscopic appendectomy patients was 24.5 years, while for open appendectomy it was 24.0 years. In terms of gender, 70 males and 30 females underwent laparoscopic appendectomy, compared to 65 males and 35 females in the open appendectomy. The mean WBC count was slightly higher in the laparoscopic group (12.8 ? 1.25) compared to the open group (12.5 ? 1.25). BMI values were also comparable between groups, with a mean of 22.5 ? 2.75 in the laparoscopic group and 21.5 ? 3.5 in the open group. For operative findings, 80 patients in the laparoscopic group had an inflamed appendix, while 75 in the open group did. Regarding ultrasound findings, 65 patients in the laparoscopic group had inflamed appendices, compared to 80 in the open group, while normal - looking appendices were noted in 35 and 20 patients, respectively. . Histopathologically, the presence of an inflamed appendix was confirmed in 86 laparoscopic cases and 87 open cases, while normal appendices were seen in 14 laparoscopic and 13 open cases. The operative time was significantly longer for the laparoscopic group (52 ? 15.0 minutes) compared to the open group (30 ? 12.5 minutes). Laparoscopic appendectomy patients required fewer doses of parenteral analgesics (0.95 ? 0.45) compared to open appendectomy patients (1.5 ? 0.5). Oral analgesic use was similar between groups. Laparoscopic patients resumed oral intake faster (18.5 ? 2.75 hours) than open patients (24.5 ? 4.5 hours). Hospital stay was significantly shorter in the laparoscopic group (1.5 ? 0.75 days) compared to the open group (3.25 ? 1.25 days). Additionally, laparoscopic patients returned to normal activity sooner (11.5 ? 3.5 days) than open appendectomy patients (20.5 ? 3.5 days). Overall, laparoscopic appendectomy was associated with better postoperative recovery outcomes Conclusion: The comparison between laparoscopic and open appendectomy shows that while patient demographics and preoperative findings are similar between the two groups, laparoscopic appendectomy offers significant advantages in postoperative outcomes and complications. Although the operative time for laparoscopic surgery is longer, it results in faster recovery, as evidenced by reduced parenteral analgesic requirements, earlier resumption of oral intake, shorter hospital stays, and quicker return to normal activity. Furthermore, laparoscopic appendectomy is associated with fewer postoperative complications, including a lower incidence of vomiting, paralytic ileus, wound infections, and no cases of wound dehiscence. These findings suggest that laparoscopic appendectomy is a more favorable option for patients, offering improved postoperative recovery and fewer complications compared to the open appendectomy approach.

Keywords: laparoscopic appendectomy, open appendectomy, postoperative recovery, acute appendicitis, clinical outcomes

Edition: Volume 13 Issue 12, December 2024

Pages: 1827 - 1835

DOI: https://www.doi.org/10.21275/MR241228033830

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