World Journal of Laparoscopic Surgery

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VOLUME 14 , ISSUE 1 ( January-April, 2021 ) > List of Articles

Original Article

Laparoscopic or Open Appendectomy: Which Approach is the Best for Complicated Appendicitis?

Ruhi F Jailani, Norjazliney A Jafri, Gerald Henry, Ismail Sagap

Keywords : Laparoscopic, Appendectomy, Complicated appendicitis

Citation Information : Jailani RF, Jafri NA, Henry G, Sagap I. Laparoscopic or Open Appendectomy: Which Approach is the Best for Complicated Appendicitis?. World J Lap Surg 2021; 14 (1):1-4.

DOI: 10.5005/jp-journals-10033-1430

License: CC BY-NC 4.0

Published Online: 00-04-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Appendicitis is more common in children and young adults. Treatment of appendicitis is either laparoscopic appendicectomy (LA) or open appendicectomy (OA) surgery. Aim and objective: The 30-day postoperative morbidity, surgical site infection, and reoperation rate were compared between open and laparoscopic appendicectomies for complicated appendicitis. Secondary outcome measures were the length of hospital stay, duration of surgery, surgical waiting time, identification of other diseases, and patient satisfaction. Materials and methods: This retrospective study was conducted in two institutions: Hospital Selayang, Selangor, Malaysia, and HUKM, Kuala Lumpur, Malaysia. Data were collected from January 2014 to December 2015 were reviewed. Results: The mean age (±SD) for LA and OA were 32 (±15) and 30 (±14) years, respectively. The males showed predominance in LA and OA with 52 and 72%, respectively (p < 0.001). The majority of LA (73%) and OA (88%) were performed by the trainees (p < 0.001). There was a significant reduction in postoperative morbidity in LA compared to OA in terms of surgical site infection, LA vs OA [n = 8 (2.7) vs 26 (6.3), p = 0.029] and duration of surgery [LA vs OA 84 (±39) vs 68 (± 6) days (p < 0.001)]. However, for LA and OA, there were no significant differences in reoperation, 0.7 and 1.0%, respectively (p = 1.000), and length of stay in LA vs OA 3.55 (±2) vs 3.89 (±3) days, respectively (p = 0.103). Overall, patient satisfaction scores were not found statistically significant as the response rates were only 32% in LA and 30% in OA. Conclusion: LA significantly reduced surgical site infection and offered an advantage in the detection of other pathologies. Hence, a laparoscopic approach should be offered to patients whose clinical diagnoses are challenging.


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