Page 64 - tmp

Comparative Study between Open and Laparoscopic Appendicectomy
Table 1: Age-group of patients who underwent appendicectomy Table 6: Return to routine work time for patients who underwent
appendicectomy
Open Laparoscopic
Age appendicectomy appendicectomy Return to
(years) (n = 34) Percentage (n = 67) Percentage routine Open Laparoscopic
20–30 7 20.58 31 46.26 work appendicectomy appendicectomy
31–40 10 29.41 15 22.38 (days) (n = 34) Percentage (n = 67) Percentage
41–50 5 14.70 10 14.92 7 days or 15 44.11 45 67.16
less
51–60 8 23.52 4 5.97 8–14 days 10 29.41 15 22.38
61–70 4 11.76 7 10.44
More than 9 26.47 7 10.44
15 days

Table 2: Gender of patients who underwent appendicectomy
1
Open Laparoscopic initially came from Germany and was published by Pier et al.
appendicectomy appendicectomy Laparoscopic appendicectomy has several advantages over the
Gender (n = 34) Percentage (n = 67) Percentage conventional open method of appendicectomy. In the laparoscopic
Male 20 58.82 40 59.70 method, the patient’s recovery is quicker, and the patient can also
Female 14 41.17 27 40.29 return to his or her routine work at the earliest. The amount of pain
that the patient may endure is far less in the laparoscopic method
than in the open method. Ortega et al., in their study of 135 patients,
Table 3: Presentation of patients with appendicitis
showed that the pain level was much less in the laparoscopic
2
Presentation No. of patients Percentage method as compared to the open method. The problem of
Abdominal pain over the right lower 72 71.28 wound infection is also much less in the laparoscopic method.
quadrant Marzouk et al. also showed in his study that the postoperative
3
Nausea 20 19.80 wound infection rate was much less in the laparoscopic method.
Vomiting 25 24.75 The length of hospital stay is significantly reduced if a laparoscopic
Fever 45 44.55 appendicectomy is done as compared to the open method. In their
4
5
6
studies, Ray-Offor et al., Rbihat et al., and Vellani et al., showed
Table 4: Duration of hospital stay for patients who underwent that the length of hospital stay was much shorter for the patients
appendicectomy who underwent laparoscopic appendicectomy. In our study, the
patients who underwent laparoscopic appendicectomy had a
Duration hospital stay of 3 days or less after surgery. The operative time is also
of hospital reduced quite a bit in case of laparoscopic appendicectomy. Our
stay after Open Laparoscopic
surgery appendicectomy appendicectomy study also shows that most of our patients had an operative time
(days) (n = 34) Percentage (n = 67) Percentage of 60 minutes or less. The need for analgesia reduces significantly
3 days 28 82.35 60 89.55 in the case of laparoscopic appendicectomy. Biondi et al., in their
study of 593 patients, showed that laparoscopic appendicectomy
or less
was associated with a shorter hospital stay, with a less need for
4–7 days 4 11.76 5 7.46 analgesia and with a faster return to daily activities. Shaikh et al.
7
8–15 days 2 5.88 2 2.98 also showed in their study the need for lesser requirement of
8
analgesia following laparoscopic appendicectomy. Li et al. also
9
reported similar findings in their meta-analysis. In the case of
Table 5: Duration of surgery for patients who underwent appendicectomy
young women, further care is needed while making a diagnosis of
Duration Open Laparoscopic appendicitis since the differential diagnosis of right lower quadrant
of surgery appendicectomy appendicectomy pain is extensive and includes gynecologic pathology as well. In
10
(minutes) (n = 34) Percentage (n = 67) Percentage addition, Azaro et al. had previously conducted studies to show
60 20 58.82 37 55.22 that laparoscopic appendicectomy is a safe procedure. The port
11
minutes placement and the sites of the incisions are extremely important
or less while performing laparoscopic appendicectomy. Studies have been
61–90 10 29.41 23 34.32 done to improve cosmesis in cases of laparoscopic appendicectomy
minutes (Tables 7 and 8). 12
91–120 4 11.76 7 10.44
minutes
conclusIon
From our study, it was found that laparoscopic appendicectomy
dIscussIon (66.33%) was the preferred choice of surgery for appendicitis. The
Today, laparoscopic appendicectomy is considered a safe and hospital stay was 3 days or less for most of our patients. Moreover,
effective method to treat appendicitis. When a patient is admitted 82.35% of patients who underwent open appendicectomy and
in the hospital with appendicitis, initially antibiotics must be started 89.55% of patients who underwent laparoscopic appendicectomy
and then a decision must be taken on the need for appendicectomy. stayed in the hospital for only 3 days or less after surgery. The
A large series of laparoscopic appendicectomy for acute appendicitis duration of surgery was 60 minutes or less in 58.82% of patients

206 World Journal of Laparoscopic Surgery, Volume 14 Issue 3 (September–December 2021)