World Journal of Laparoscopic Surgery

Register      Login

VOLUME 15 , ISSUE 3 ( September-December, 2022 ) > List of Articles

Original Article

Clinical Outcomes of Laparoscopic vs Mini-incision Open Appendectomy: A Comparative Study

Shams Ul Bari, Aamir Farooq

Keywords : Appendectomy, Appendicitis, Laparoscopy, Pneumoperitoneum, Visual analog scale

Citation Information : Bari SU, Farooq A. Clinical Outcomes of Laparoscopic vs Mini-incision Open Appendectomy: A Comparative Study. World J Lap Surg 2022; 15 (3):193-198.

DOI: 10.5005/jp-journals-10033-1479

License: CC BY-NC 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Open appendectomy was first introduced by McBurney and has been considered as the treatment of choice for more than a century for acute appendicitis. However, recently, laparoscopic appendectomy (LA) has become the popular method of treatment for patients with acute appendicitis. Aims and objectives: The aim of this study was to compare results of LA with mini-incision open appendectomy in terms of various parameters such as time taken to complete the procedure, postoperative pain, need for analgesia, hospital stay, days to return to normal activity cosmetic results, and complications. Material and methods: This study was a prospective study conducted in the Department of Surgery, SKIMS Medical College, Bemina, Srinagar, Jammu and Kashmir, India, from July 2017 to June 2019. All patients more than 14 years in age admitted in the accident emergency department of the hospital with a clinical diagnosis of acute appendicitis were included in the study. Results and observations: Total number of patients studied was 101 and were randomly taken either for mini-incision open appendectomy or laparoscopic surgery. The two groups were comparable with respect to age and sex distribution with no statistically significant difference. The average operative time in mini-incision appendectomy (MIA) group was 32.7 ± 2.52 (30–35 years of age) compared to 26.9 ± 2.46 (24–30 years of age) in laparoscopic group, which was statistically significant. The patients with laparoscopic surgery experienced less pain and had less postoperative wound infection as compared to MIA group with p <0.001, which was statistically significant. Conclusion: Comparison done on the basis of statistical results between the two groups was suggestive of superiority of LA over MIA.


PDF Share
  1. Prystowsky JB, Pugh CM, Nagle AP. Current problems in surgery. Appendicitis. Curr Probl Surg 2005;42(10):688–742. DOI: 10.1067/j.cpsurg.2005.07.005.
  2. Majeed AW, Troy G, Nicholl JP, et al. Randomized, prospective, single-blind comparison of laparoscopic versus small-incision cholecystectomy. Lancet 1996;347(9007):989–994. DOI: 10.1016/s0140-6736(96)90143-9.
  3. Hellberg A, Rudberg C, Kullman E, et al. Prospective randomized multicentre study of laparoscopic versus open appendicectomy. Br J Surg 1999;86(1):48–53. DOI: 10.1046/j.1365-2168.1999.00971.x.
  4. Heikkinen TJ, Haukipuro K, Hulkko A. Cost-effective appendectomy. Open or laparoscopic? A prospective randomized study. Surg Endosc 1998;12(10):1204–1208. DOI: 10.1007/s004649900821.
  5. Katkhouda N, Mason RJ, Towfigh S, et al. Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg 2005;242(3):439–448. DOI: 10.1097/01.sla.0000179648.75373.2f.
  6. Ellis H, Nathanson LK. Maingot's abdominal operations. In: Michael JZ, Stanley WA, Douglas SS, editors. Appendix and Appendectomy, 11th edition, New York: McGraw-Hill Professional, 2007, pp.589–608.
  7. Frazee RC, Roberts JW, Symmonds RE, et al. A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg 1994;219(6):725–728. DOI: 10.1097/00000658-199406000-00017.
  8. Golub R, Siddiqui F, Pohl D. Laparoscopic versus open appendectomy: A meta-analysis. J Am Coll Surg 1998;186:545–553. DOI: 10.1016/s1072-7515(98)00080-5.
  9. Chung RS, Rowland DY, Li P. A meta-analysis of randomized controlled trials of laparoscopic versus conventional appendectomy. Am J Surg 1999;177(3):250–256. DOI: 10.1016/s0002-9610(99)00017-3.
  10. Sauerland S, Lefering R, Holthausen U, et al. Laparoscopic vs conventional appendectomy: A meta-analysis of randomized controlled trials. Arch Surg 1998;383(3–4):289–295. DOI: 10.1007/s004230050135.
  11. Sauerland S, Lefering R, Neugebauer EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2002;1:CD001546. DOI: 10.1002/14651858.CD001546.
  12. Deshmukh S, Verde F, Johnson PT, et al. Anatomical variants and pathologies of the vermix. Emerg Radiol 2014;21:543–552. DOI: 10.1007/s10140-014-1206-4.
  13. Uptal D. Laparoscopic vs open appendectomy. Chin J Dig Dis 2005;6:165–169. DOI: 10.1111/j.1443-9573.2005.00225.x.
  14. Novarra G, Ascanelli S, Turini A, et al. Laparoscopic appendectomy versus open appendectomy in suspected acute appendicitis in female patients. Ann Ital Chir 2002;73:59–63. PMID: 12148423.
  15. Kamran H, Naveed D, Nazir A, et al. The role of total leukocyte count in the diagnosis of acute appendicitis. J Ayub Med Coll Abbottabad 2008;20:70–72. PMID: 19610521.
  16. Andersen BR, Kallehave FL, Andersen HK. Antibiotics versus placebo for prevention of postoperative infection after appendicectomy. Cochrane Database Syst Rev 2005;3:CD001439. DOI: 10.1002/14651858.CD001439.pub2.
  17. Nguyen NT, Zainabadi K, Mavandadi S, et al. Trends in utilization and outcomes of laparoscopic versus open appendectomy. Am J Surg 2004;188:813–820. DOI: 10.1016/j.amjsurg.2004.08.047. PMID: 15619505.
  18. Islam SR, Pasha K, Rahman S, et al. Laparoscopic vs open appendectomy: A comparative study. Bangladesh J Endosurg 2014;2(1):5–8.
  19. Özsan I, Karabuğa T, Yoldaş O, et al. Laparoscopic appendectomy versus mini-incision appendectomy in patients with lower body mass index and non-complicated appendicitis. Gastroenterol Res Pract 2014;2014:138648. DOI: 10.1155/2014/138648.
  20. Naraintran S, Kumar S, David S, et al. Laparoscopic versus open appendectomy: A comparative study. Int Surg J 2018;5(4):1240–1245. DOI: 10.18203/2349-2902.isj20181055.
  21. Kushwah N, Kushwah R. A comparative study between laparoscopic appendectomy and conventional open appendectomy. Int J Appl Res 2015;1(12):308–314.
  22. Shaikh AR, Sangrasi AK, Shaikh GA. Clinical outcomes of laparoscopic versus open appendectomy. JSLS 2009;13(4):574–580. DOI: 10.4293/108680809X1258998404524.
  23. Pedersen AG, Petersen OB, Wara P, et al. Randomized clinical trial of laparoscopic versus open appendicectomy. Br J Surg 2001;88:200–205. DOI: 10.1046/j.1365-2168.2001.01652.x.
  24. Garbutt JM, Soper NJ, Shannon WD, et al. Meta-analysis of randomized controlled trials comparing laparoscopic and open appendectomy. Surg Laparosc Endosc 1999;9:17–26. PMID: 9950122.
  25. Biondi A, Di-Stefano C, Ferrara F, et al. Retrospective cohort study between laparoscopic and open appendectomy. World J Emerg Surg 2016;11(1):44. DOI: 10.1186/s13017-016-0102-5. eCollection 2016.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.