A Comparative Study Between Laparoscopic Appendectomy and Conventional Open Appendectomy
Objective: A comparative study between laparoscopic appendectomy and conventional open appendectomy (OA). Materials and Methods: Our study was carried out on 88 patients admitted in surgical wards of Sanjay Gandhi Memorial Hospital associated with S. S. Medical College Rewa, Madhya Pradesh. Patients of acute and/or recurrent appendicitis, or cases who came for interval appendectomy, admitted through casualty or transferred from other department or reported in OPD during the period of study were included in the study. Detailed history and clinical examination, baseline blood investigations, and radiological investigations were done. Initial conservative management, including IV fluid resuscitation with Ringer’s lactate solution/Foley’s catheterization/nasogastric intubation, was done as per need. Operative procedure (laparoscopic appendectomy or OA) was planned and performed as per the patient choice and patient’s consent of that particular operation and patient’s pre-operative condition. Both procedures were compared in relation to duration of operation, post-operative pain, postoperative hospital stay, complications, conversion rate, time taken for return to normal activity, diagnosis of additional pathologies, relief of symptoms, and cosmesis. Result: Laparoscopic appendectomy is better as compare to OA in relation to post-operative pain, post-operative hospital stay, early return to normal activity, diagnosis of additional pathologies (especially in female patients and patients with diagnostic uncertainty), and subjective cosmesis. Disadvantage of laparoscopic appendectomy is longer mean operating time and conversion into OA. Overall complication rate and relief of symptoms are similar in laparoscopic and OA group. Conclusion: Laparoscopic appendectomy is thus a safe, simple, and efficient technique for treatment of appendicitis in experienced hands. Cases with unsure anatomy due to adhesions were the most difficult to complete laparoscopically and may needed to convert into open method and duration of operation is more in laparoscopic appendectomy.