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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 15, Issue 3, July 2015 pp 581-586
A comparative study between open appendicectomy and laparoscopic appendicectomy
Sachin Subhash Pawar1, S H Kulkarni2, Vijay S Kullolli3
1Senior Resident, 2Professor, 3Consultant, Kullolli Hospital, Sangli, Maharashtra, INDIA.
Aims and objectives of the study: To study and compare the results of Laparoscopic appendicectomy (LA) and Open appendicectomy (OA) with reference to the: Operative time, post-operative complications, post-operative pain, time taken for oral resumption, hospital stay and resume of household activities/regular work by patients. Materials and Methods: All clinically diagnosed cases of appendicitis in patients presenting at Kullolli Hospital, Vishram Bag, and Sangli. 50 cases each of open appendicectomy and laparoscopic appendicectomy were studied. Patients were informed about the study in all respects and a written and informed consent was obtained. Method of collection of data: By History, by clinical examination and by Laboratory investigations. Method: All the screened patients after relevant examination, laboratory tests and pre-operative fitness, were allotted in one of the two groups namely: Open appendicectomy by McBurney’s grid-iron incision and Laparoscopic Appendicectomy by standard 3 ports. Results: The mean duration of operation (calculated from beginning of skin incision to completion of skin closure) was significantly longer in LA than in OA group (60.1min. Vs 32.6 min respectively, p<0.001). Patients in LA group had a highly significant less pain (mean pain score at 48 hrs post-operatively 4.85 Vs 6.63, p=0.001) as compared to those in OA group. The overall post-operative complication rate in OA group was 6% and in LA group was 0%. There is a significant earlier return to oral feeds after LA than after OA (25.44 hrs. vs. 30.64 hrs. p= 0.006). In the present series there is a highly significant reduction in the post-operative hospital stay in LA group as compared to OA group (3.90 days vs. 6.68 days, p=0.001). In the present series the time taken for resumption of home activities/work is significantly lesser in LA group than in OA group (9.42 days vs. 16.54 days, p=0.001). Conclusion: This study concluded that in experienced hands laparoscopic appendicectomy had a definite advantage over open appendicectomy with reference to less post-operative pain, shorter hospital stay, earlier oral feed resumption and earlier return to regular work in the former. Only operative time was longer in laparoscopic appendicectomy which can still be reduced with more case experience.