Evaluation of Laparoscopic Appendectomy vs. Open Appendectomy
Abstract
Aims and objectives: The basic aim of the study is
to analyze laparoscopic appendectomy in com-
parison with open appendectomy with respect to
surgical site infection. Material and methods: This
study was conducted at Sheikh Zayed Hospital, Ra-
him Yar Khan during January 2019 to September
2019. This study include 100 patients diagnosed
as appendicitis and operated. Their mean age was
33.32 ± 20.80 years. OA was performed through right
lower quadrant transverse muscle-splitting incision.
The thread ties were placed on the base of the ap-
pendix. Results: Of these 100 patients, 85 (63.4%)
had acute appendicitis and 20 (20.1%) appendices
were perforated. There were 80 patients in the LA
group and 54 in the OA group; however, 9 patients
had a conversion to an open procedure. The overall
SSI rate was not different between the two groups
(2.8% for the OA group vs. 4.6% for the LA group, re-
spectively, P=0.204), but the superficial SSI rate was
significantly lower in the LA group (3.2% vs. 0.6%, P
= 0.016). Conclusion: It is concluded that advantages
of diagnostic laparoscopy in patients with abdominal
pain, combined with the benefits of laparoscopic ap-
pendectomy, suggest that all patients with suspected
appendicitis should be considered for laparoscopic
appendectomy provided appropriately trained per-
sonnel and adequate equipment are available.
INTRODUCTION: Laparoscopic surgery has gained in
popularity and found application in almost every sur-
gical specialty. The management of many diseases
has benefited from the application of the laparoscop-
ic approach. Laparoscopic appendectomy is one such
procedure increasing in popularity since initially re-
ported by Semm in 1983. Several studies have shown
the advantages of laparoscopic surgery in terms of
shorter hospital stay, rapid postoperative recovery,
and better pain control. However, there have been
concerns about the risk of infectious complications,
particularly the development of intra-abdominal ab-
scess and superficial wound infection. This risk is sig-
nificantly increased in cases of perforated appendici-
tis [1]. Acute appendicitis is one of the most common
causes of acute abdomen in all ages. It occurs more
frequently in men than in women (male/female:
1.3/1); the mean and median ages related to this
pathology are 31.3 and 22 years, respectively. Open
appendectomy (OA), which was first described by
McBurney in 1894, is the most frequently performed
emergency abdominal operation in the world. How-
ever, the use of the laparoscopic appendectomy (LA)
procedure has rapidly increased since it was first de-
scribed by Semm in 1984. Although LA is commonly
performed for acute appendicitis, it is not always the
best treatment choice [2]. Many studies comparing
LA and OA with respect to treatment and follow-up
have been conducted. These studies have reported
less postoperative surgical-site infection, decreased
need for analgesics, much greater visualization, rapid
healing, shorter hospital stay times, and earlier re-
turn to normal activity (RTNA) rates associated with
LA. However, because of the high costs related to
endostaplers, endoclips, and knottings, LA is not the
most efficient operation technique [3]. Open appen-
dectomy (OA), which was described first by McBur-
ney in 1894, has been accepted as the gold standard
of appendectomy for around 100 years. However,
since its introduction by Semm in 1983, laparoscopic
appendectomy (LA) has been conducted more fre-
quently than OA due to its advantages of being min-
imally invasive [4]. In particular, more attention has
