Original Article Section: Surgery Comparative Study of Laparoscopic Versus Open Appendicectomy for Acute Appendicitis -A Prospective Study
EAES Academy. DEVKARAN B. 07/05/22; 363099; P144
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Abstract
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Background:
Acute appendicitis is the most common cause of an “acute abdomen” in young adults. Appendicectomy is the most common procedure performed in emergency surgery. There is lack of consensus for the most appropriate technique for appendicectomy. Laparoscopic appendicectomy has not become gold standard treatment for acute appendicitis unlike laparoscopic cholecystectomy for gallstone disease. The advantages of laparoscopic appendicectomy over open appendicectomy are questioned time and again. There have been many studies which concluded that laparoscopic appendicectomy is better as compared to open appendicectomy in patients of acute appendicitis in many aspects. Objective: The primary objective of this study was to compare the outcomes of laparoscopic and the open approach in the treatment of acute appendicitis. Methods: The study included 400 cases of appendicectomy, 200 open and 200 laparoscopic, which were randomly selected and were operated in the department of general surgery, Indira Gandhi Medical College Shimla. The following parameters were compared between the two groups: operative time, blood loss, intra-operative complications, analgesic requirement for first 48 hours, time to start ambulation, time for the bowel sounds to recover, time to start clear liquids and regular diet, wound status, discharge from the hospital (post op day), postoperative complications, time taken for return to normal activity and cosmetic outcome. Chi-square test and student t-test were used for statistical analysis. Results: Present study clearly proves that laparoscopic appendicectomy is better as compared to open appendicectomy in terms of post-operative pain, analgesic requirement, time to start ambulation, hospital stay, time to return to normal activity and cosmetic outcome. Laparoscopic appendicectomy was comparable to open appendicectomy in terms of operative time, time required for the bowel sounds to recover, time to start liquids and regular diet, wound infection and other complications in the present study. Conclusion: Laparoscopic technique in appendicectomy is safe and it clearly provides advantages over the open technique.
Acute appendicitis is the most common cause of an “acute abdomen” in young adults. Appendicectomy is the most common procedure performed in emergency surgery. There is lack of consensus for the most appropriate technique for appendicectomy. Laparoscopic appendicectomy has not become gold standard treatment for acute appendicitis unlike laparoscopic cholecystectomy for gallstone disease. The advantages of laparoscopic appendicectomy over open appendicectomy are questioned time and again. There have been many studies which concluded that laparoscopic appendicectomy is better as compared to open appendicectomy in patients of acute appendicitis in many aspects. Objective: The primary objective of this study was to compare the outcomes of laparoscopic and the open approach in the treatment of acute appendicitis. Methods: The study included 400 cases of appendicectomy, 200 open and 200 laparoscopic, which were randomly selected and were operated in the department of general surgery, Indira Gandhi Medical College Shimla. The following parameters were compared between the two groups: operative time, blood loss, intra-operative complications, analgesic requirement for first 48 hours, time to start ambulation, time for the bowel sounds to recover, time to start clear liquids and regular diet, wound status, discharge from the hospital (post op day), postoperative complications, time taken for return to normal activity and cosmetic outcome. Chi-square test and student t-test were used for statistical analysis. Results: Present study clearly proves that laparoscopic appendicectomy is better as compared to open appendicectomy in terms of post-operative pain, analgesic requirement, time to start ambulation, hospital stay, time to return to normal activity and cosmetic outcome. Laparoscopic appendicectomy was comparable to open appendicectomy in terms of operative time, time required for the bowel sounds to recover, time to start liquids and regular diet, wound infection and other complications in the present study. Conclusion: Laparoscopic technique in appendicectomy is safe and it clearly provides advantages over the open technique.
Background:
Acute appendicitis is the most common cause of an “acute abdomen” in young adults. Appendicectomy is the most common procedure performed in emergency surgery. There is lack of consensus for the most appropriate technique for appendicectomy. Laparoscopic appendicectomy has not become gold standard treatment for acute appendicitis unlike laparoscopic cholecystectomy for gallstone disease. The advantages of laparoscopic appendicectomy over open appendicectomy are questioned time and again. There have been many studies which concluded that laparoscopic appendicectomy is better as compared to open appendicectomy in patients of acute appendicitis in many aspects. Objective: The primary objective of this study was to compare the outcomes of laparoscopic and the open approach in the treatment of acute appendicitis. Methods: The study included 400 cases of appendicectomy, 200 open and 200 laparoscopic, which were randomly selected and were operated in the department of general surgery, Indira Gandhi Medical College Shimla. The following parameters were compared between the two groups: operative time, blood loss, intra-operative complications, analgesic requirement for first 48 hours, time to start ambulation, time for the bowel sounds to recover, time to start clear liquids and regular diet, wound status, discharge from the hospital (post op day), postoperative complications, time taken for return to normal activity and cosmetic outcome. Chi-square test and student t-test were used for statistical analysis. Results: Present study clearly proves that laparoscopic appendicectomy is better as compared to open appendicectomy in terms of post-operative pain, analgesic requirement, time to start ambulation, hospital stay, time to return to normal activity and cosmetic outcome. Laparoscopic appendicectomy was comparable to open appendicectomy in terms of operative time, time required for the bowel sounds to recover, time to start liquids and regular diet, wound infection and other complications in the present study. Conclusion: Laparoscopic technique in appendicectomy is safe and it clearly provides advantages over the open technique.
Acute appendicitis is the most common cause of an “acute abdomen” in young adults. Appendicectomy is the most common procedure performed in emergency surgery. There is lack of consensus for the most appropriate technique for appendicectomy. Laparoscopic appendicectomy has not become gold standard treatment for acute appendicitis unlike laparoscopic cholecystectomy for gallstone disease. The advantages of laparoscopic appendicectomy over open appendicectomy are questioned time and again. There have been many studies which concluded that laparoscopic appendicectomy is better as compared to open appendicectomy in patients of acute appendicitis in many aspects. Objective: The primary objective of this study was to compare the outcomes of laparoscopic and the open approach in the treatment of acute appendicitis. Methods: The study included 400 cases of appendicectomy, 200 open and 200 laparoscopic, which were randomly selected and were operated in the department of general surgery, Indira Gandhi Medical College Shimla. The following parameters were compared between the two groups: operative time, blood loss, intra-operative complications, analgesic requirement for first 48 hours, time to start ambulation, time for the bowel sounds to recover, time to start clear liquids and regular diet, wound status, discharge from the hospital (post op day), postoperative complications, time taken for return to normal activity and cosmetic outcome. Chi-square test and student t-test were used for statistical analysis. Results: Present study clearly proves that laparoscopic appendicectomy is better as compared to open appendicectomy in terms of post-operative pain, analgesic requirement, time to start ambulation, hospital stay, time to return to normal activity and cosmetic outcome. Laparoscopic appendicectomy was comparable to open appendicectomy in terms of operative time, time required for the bowel sounds to recover, time to start liquids and regular diet, wound infection and other complications in the present study. Conclusion: Laparoscopic technique in appendicectomy is safe and it clearly provides advantages over the open technique.
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