COMPARATIVE STUDY BETWEEN LAPAROSCOPIC VS OPEN APPENDECTOMY IN ACUTE APPENDICITIS
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Keywords
laparoscopic appendectomy, open appendectomy, acute appendicitis, minimally invasive surgery, postoperative outcomes
Abstract
Background: Acute appendicitis remains the most common surgical emergency, with appendectomy being one of the most frequently performed surgical procedures worldwide. While open appendectomy has been the traditional gold standard, laparoscopic appendectomy has emerged as a viable alternative with potential advantages in terms of reduced morbidity and faster recovery. This study aimed to compare clinical outcomes, complications, and cost-effectiveness between laparoscopic and open appendectomy techniques in patients with acute appendicitis.
Methods: A prospective comparative study was conducted at NIMS, Jaipur, from January 2011 to December 2011. A total of 240 patients with acute appendicitis were enrolled, with 120 patients in each group (laparoscopic and open appendectomy). Data collection included demographic characteristics, operative parameters, postoperative pain scores using visual analog scale, recovery metrics, complications, and cost analysis. Statistical analysis was performed using SPSS version 20.0, with significance set at p<0.05.
Results: Laparoscopic appendectomy demonstrated significantly longer operative time (52.6±18.4 vs 38.2±12.7 minutes, p<0.001) but superior outcomes in multiple domains. Postoperative pain scores were consistently lower at all time points (VAS at 6 hours: 4.2±1.8 vs 6.8±2.1, p<0.001). Hospital stay was significantly shorter (1.8±0.9 vs 3.2±1.4 days, p<0.001), with faster return to normal activities (8.4±3.6 vs 14.7±5.8 days, p<0.001). Overall complication rates were lower in the laparoscopic group (10.0% vs 23.3%, p=0.006), particularly wound infections (2.5% vs 15.0%, p<0.001). Patient satisfaction scores were significantly higher across all measured domains.
Conclusions: Laparoscopic appendectomy offers significant advantages over open appendectomy including reduced postoperative pain, shorter hospital stays, lower complication rates, and higher patient satisfaction, supporting its adoption as the preferred surgical approach for acute appendicitis in appropriately selected patients.
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Dr. Birendra Kumar
Assistant Professor, Department of General Surgery, National Institute of Medical Sciences (NIMS), Jaipur, Rajasthan.