Comparison of Open Appendectomy and Laparoscopic Appendectomy in Perforated Appendicitis

Abstract

Introduction Laparoscopic appendectomy for nonperforated appendicitis is associated with improved outcomes. This study compares laparoscopic appendectomy and open appendectomy in cases of a perforated appendix by assessing surgical site infection, mean operating time, and length of hospital stay. Materials and methods This study was a prospective randomized study conducted at the Department of Surgery, Holy Family Hospital, Rawalpindi, Pakistan, from January 2016 to January 2017, by randomly allotting the laparoscopic or the open appendectomy technique to 130 patients by the lottery method. Patients having a perforated appendix were included after they provided informed consent. Data were entered and analyzed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY, US). Results The frequency of wound site infection was significantly higher in open appendectomy (27.69%) than in the laparoscopic approach (10.77%; p=0.01). Mean hospital stay was slightly longer in the laparoscopic approach (4.38 ± 1.09 days) than in open appendectomy (4.18 ± 0.77 days; p=0.23). Mean operating time for laparoscopic appendectomy and open appendectomy was 46.98 ± 2.99 minutes and 53.02 ± 2.88 minutes, respectively (p<0.000). Conclusion Laparoscopic appendectomy was associated with fewer surgical site infections and shorter mean operating time than an open appendectomy.

Two-Year Experiences of 500 Appendectomies in Lahore General Hospital, Lahore

“…The results contradict the findings from other research studies. The findings from the other research studies indicated that open appendectomy is associated with a shorter hospital stay than laparoscopic appendectomy [13][14][15]. Furthermore, the operative time for the two surgical procedures was considerably shorter than the operative time reported by other research studies.…”

“…Research studies that compared the operative time between the surgical procedures reported the same findings that the duration of open appendectomies was shorter than that of laparoscopic appendectomy [13][14][15]. Shimoda et al (2018) noted that the longer operative time in laparoscopic appendectomy was due to the associated complications and largely dependent on the surgeon's skill and experience [16].…”

Comparative study between Open and Laparoscopic Appendectomy in Complicated Cases

“…Seqsaqa et al, 2020. reported that the need for intraperitoneal drain insertion was significantly lower with LA than OA (p = 0.001). This significance was also reported by Horvath et al 2017; they explained that the laparoscopic technique offers a good vision to the entire abdomen and that enables the surgeon to achieve a careful suction from every quadrant having collections [30] Also, Nazir et al, 2019 [31] Additional studies suggest the laparoscopic approach is associated with longer operating times than an open appendectomy. These results were in contradiction to ours.…”

Post-operative Complications of Complicated Paediatric Appendicitis in a Tertiary Teaching Hospital

“…This was statistically significant too. Nazir A et al [13] also reports increase wound infection rates for open appendicectomy (27.69%) when compared to laparoscopic appendicectomy (10.77%). In our study SSI incidence is higher than reported by Nazir A et al [13] but the SSI in laparoscopic group is much less.…”