A comparative Clinical Trial of Laparoscopic Appendectomy versus Open Appendectomy in uncomplicated Cases
Evaluating Outcomes in Laparoscopic and Open Appendectomy
DOI:
https://doi.org/10.69750/dmls.01.05.051Keywords:
Laparoscopic appendectomy, open appendectomy, acute appendicitis, postoperative pain, patient satisfaction.Abstract
Background: Appendicitis is one of the most frequent causes of acute abdominal pain and usually leads to the surgery called appendectomy. Various advantages can be associated with laparoscopic appendectomy but possible disadvantages include longer operative time and complications.
Objectives: The purpose of this research was to find out the differences between laparoscopic appendectomy (LA) and open appendectomy (OP) in patients with uncomplicated acute appendicitis focusing on operative time, length of hospital stay, postoperative pain, postoperative complication rates, and patient satisfaction.
Methods: The present study was a Comparative randomized clinical trial performed in Farooq Teaching Hospital and Hameed Latif Teaching Hospital from January 2022 to January 2023. Two hundred patients with uncomplicated appendicitis were randomly chosen and divided into the laparoscopic appendectomy(n=100) and the open appendectomy(n=100). Primary outcomes were operative time, length of hospital stay, postoperative pain as assessed by the Visual Analog Scale, and complications. Secondary measures were time to resume normal activities, and patients’ satisfaction, measured on a Likert scale. Descriptive statistics, Student’s t-test and chi-square test were used for analysis and p≤0.05 was considered significant.
Results: Laparoscopic appendectomy took a relatively longer mean operative time (54. 9 ± 14. 2 min) in comparison with open appendectomy (31. 4 ± 11. 1 min) with p<0.001 but overall, the patients who underwent laparoscopic appendectomy had lesser hospital stay (1. 4 ± 0. 6 days) than those who underwent open appendectomy (2.7 ± 2.5 days, p<0.01). Patients were able to get back to their normal activities sooner (11. 5 ± 3. 1 days; 16. 1 ± 3. 3 days; t = -3. 80; p<0.01) and expressed higher level of satisfaction (4.7 ± 0.6 vs. 3.9 ± 0.7, p<0.01).
Conclusion: Compared to open appendectomy, laparoscopic appendectomy has a longer operative time, but the advantages include less postoperative recovery time, less postoperative pain and higher postoperative patient satisfaction.
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References
Herrod PJJ, Kwok AT, Lobo DN. Randomized clinical trials comparing antibiotic therapy with appendicectomy for uncomplicated acute appendicitis: meta-analysis. BJS Open. 2022;6(4). doi:10.1093/bjsopen/zrac100
Talha A, El-Haddad H, Ghazal AE, Shehata G. Laparoscopic versus open appendectomy for perforated appendicitis in adults: randomized clinical trial. Surg Endosc. 2020;34(2):907-14. doi:10.1007/s00464-019-06847-2
Vejdan SAK, Khosravi M, Amirian Z. Transumbilical laparoscopic-assisted appendectomy for pediatric uncomplicated appendicitis: comparison with laparoscopic and open appendectomy. J Pediatr Endosc Surg. 2021;3(1):39-46. doi:10.1007/s42804-020-00087-1
Liu BR, Kong LJ, Ullah S, Xiao M, Sun XZ, Zhang JY, et al. Endoscopic retrograde appendicitis therapy vs appendectomy for acute uncomplicated appendicitis: randomized clinical trial. J Dig Dis. 2022;23(11):636-41. doi:10.1111/1751-2980.13148
Mulita F, Plachouri KM, Liolis E, Kehagias D, Kehagias I. Intra-abdominal abscess after laparoscopic vs open appendectomy: retrospective study. Videosurgery Miniinv Tech. 2021:560-5. doi:10.5114/wiitm.2021.103942
Fujishiro J, Watanabe E, Hirahara N, Terui K, Tomita H, Ishimaru T, et al. Laparoscopic vs open appendectomy for children: nationwide retrospective study. J Gastrointest Surg. 2021;25(4):1036-44. doi:10.1007/s11605-020-04544-3
Khadilkar R, Panditrao AA, Inturi R. Comparative study of laparoscopic vs open appendectomy. Int Surg J. 2020;7(1):138-43.
Gul SI, Laharwal AR, Wani AA, Rashid A. Classical open vs small incision vs laparoscopic appendectomy in children. Int J Contemp Surg. 2020;8(1):36-9.
YPS, SV. Laparoscopic vs open appendectomy: population-based study. Int J Med Arts. 2022;4(5):2333-8. doi:10.21608/ijma.2022.131815.1446
Poprom N, Wilasrusmee C, Attia J, McEvoy M, Thakkinstian A, Rattanasiri S. Postoperative complications: open vs laparoscopic appendectomy—umbrella review. J Trauma Acute Care Surg. 2020;89(4):813-20. doi:10.1097/TA.0000000000002878
Talan DA, Di Saverio S. Treatment of acute uncomplicated appendicitis. N Engl J Med. 2021;385(12):1116-23. doi:10.1056/NEJMcp2107675
Seqsaqa M, Rozeik AE, Khalifa M, Ashri HNA. Laparoscopic vs open appendectomy in complicated pediatric appendicitis. Egypt Pediatr Assoc Gaz. 2020;68(1):26. doi:10.1186/s43054-020-00034-y
Ihnát P, Tesař M, Tulinský L, Ihnát Rudinská L, Okantey O, Durdík Š. Appendix stump closure methods during laparoscopic appendectomy: RCT. BMC Surg. 2021;21(1):272. doi:10.1186/s12893-021-01279-z
Cirocchi R, Cianci MC, Amato L, Properzi L, Buononato M, Di Rienzo VM, et al. Single-port vs conventional laparoscopic appendectomy: meta-analysis. Surg Endosc. 2024;38(4):1667-84. doi:10.1007/s00464-023-10659-w
Brucchi F, Bracchetti G, Fugazzola P, Viganò J, Filisetti C, Ansaloni L, et al. Nonoperative vs operative management for uncomplicated appendicitis: meta-analysis. World J Emerg Surg. 2024;19(1):2. doi:10.1186/s13017-023-00531-6
Takeyama H, Ikeda K, Shinomiya S, Nishigaki T, Yamashita M, Danno K, et al. Laparoscopic vs open extensive resection for complicated appendicitis. Surg Laparosc Endosc Percutan Tech. 2021;31(4):448-52. doi:10.1097/SLE.0000000000000903
Neogi S, Banerjee A, Panda SS, Ratan SK, Narang R. Laparoscopic vs open appendicectomy for complicated appendicitis in children: systematic review. J Pediatr Surg. 2022;57(3):394-405. doi:10.1016/j.jpedsurg.2021.07.005
Güler Y, Karabulut Z, Çaliş H, Şengül S. Laparoscopic vs open appendectomy: wound infection outcomes. Int Wound J. 2020;17(4):957-65. doi:10.1111/iwj.13347
Elvira López J, Sales Mallafré R, Padilla Zegarra E, Carrillo Luna L, Ferreres Serafini J, Tully R, et al. Outpatient management after laparoscopic appendectomy: RCT. World J Emerg Surg. 2022;17(1):59. doi:10.1186/s13017-022-00465-5
Podda M, Poillucci G, Pacella D, Mortola L, Canfora A, Aresu S, et al. Appendectomy vs antibiotics for uncomplicated appendicitis: ACTUAA trial. Int J Colorectal Dis. 2021;36(3):589-98. doi:10.1007/s00384-021-03843-8
Sippola S, Haijanen J, Viinikainen L, Grönroos J, Paajanen H, Rautio T, et al. QoL and satisfaction at 7-year follow-up: antibiotics vs appendectomy. JAMA Surg. 2020;155(4):283-9. doi:10.1001/jamasurg.2019.6028
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