Introduction
Laparoscopic appendectomy is currently considered the operation of choice for patients with suspected acute appendicitis. This study aimed to assess the safety and feasibility of laparoscopic appendectomy in the setting of a secondary referral hospital.
Methods
A retrospective cohort study was conducted from January 2021 to December 2023. Records of patients older than 14 years of age who underwent appendectomy were retrieved. Patients were divided according to the type of technique used into two groups: group I (G1) consisted of patients who underwent laparoscopic appendectomy and group II (G2) included those with an open appendectomy. Patients who underwent interval appendectomy or incidental to other procedures were excluded. The two groups were compared in terms of patient demographics, pathological findings, operative time, postoperative course, and outcome.
Results
Laparoscopic appendectomy was performed in 101 patients while open appendectomy was done in 121 patients. There were no statistical differences between both groups regarding operative time, blood loss, time for oral intake resumption, hospital stay, or postoperative complications. Despite being not statistically significant, surgical site infection was lower in G1 as compared to G2 (3% versus 8.3%, p=0.09). Narcotic use was significantly less following laparoscopic appendectomy. In the late settings cases of G1, there was a relatively improved mean operative time (32.7 ±18.3) when compared to early settings appendectomy (62.4±26.3), which was statistically significant (
P
=0.001).
Conclusion
Laparoscopic appendectomy is safe, feasible, and adoptable even by junior staff. Therefore, it could be applicable in settings of secondary referral hospitals as an initial line of management when performed by an expert surgeon or trainee under the supervision of seniors.