Volume: 7 Issue: 1
Year: 2019, Page: 45-48,
Background: Laparoscopic Appendectomy [LA] is widely practiced than Open Appendectomy [OA] for the management of acute appendicitis1. It is still unclear in rural settings which procedure is more preferable.
Aims and Objectives: The current study was done to compare the safety and the advantages of both the procedures in rural settings of Telangana state.
Materials and Methods :One hundred and eighty patients were randomly divided into two groups, OA [Open Appendectomy group] and LA [Laparoscopic Appendectomy] group. Socio demographic parameters, primary outcome measures of the patients such as post operative pain, wound infection, hospital stay, operative duration, cost of the procedure were collected and analyzed. Percentages were calculated for categorical data, numerical data was represented using mean ± S.D. Chi square test was used for comparing categorical and numerical variables.
Results:After randomization, 90 patients were in group OA, 90 patients were in group LA. The mean duration of surgery was 32.67 ± 5.229 in OA and 47.25± in LA, pain scores were less in LA than OA. Cost of the surgery was more in LA [mean average Rupees 21,453] over OA [mean average Rupees 12,865]. Conclusion:LA is safe and superior to OA with respect to lesser pain in postoperative period, less wound infection, earlier return of bowel sounds, short hospital stay and better cosmetic look. The cost of the procedure has big impact over patient’s socioeconomic conditions in rural parts which should be addressed by health care providers.
Keywords: Open appendectomy, laparoscopic appendectomy, cost of surgery
1. Xiaohang Li, Jialin Zhang et al : laparoscopic versus conventional appendectomy – a meta analysis of randomized controlled trials, BMC Gastroenterology 2010; 10:129.
2. Yasmin Vellani, Shabeena Bhatti et al : evaluation of laparoscopic appendectomy versus open appendectomy: a retrospective study at Aga khan university hospital, Karachi, Pakistan ; JPMA 2009; vol 59: 605-608.
3. Mc Burney C. An incision is made in the abdominal wall in cases of appendicitis, with a description of a new method of operating . Ann Surg 1894;20: 38-43.
4. Semm K. Endoscopic appendectomy. Endoscopy 1983; 59 - 64.
5. Gross E, et al. Laparoscopic versus conventional appendectomy – a comparison with reference to early postoperative complication. Zentrabl Chir 1998; 123: 858- 62.
6. Schwartz Principles of Surgery, 9th Edition, 2010, The Mc Graw Hill Companies, Inc.
7. Wewers M.E. & Lowe N.K. A critical review of visual analogue scales in the measurement of clinical phenomena. Research in Nursing and Health 1990;13: 227 - 236.
8. Chung CH, Ng CP, Lai KK. Delays by patients, emergency physicians, and surgeons in the management of acute appendicitis : retrospective study. Hong Kong Med J 2000; 254-9.
9. Lee SL, Walsh AJ, Ho HS. Computed tomography and ultrasonography do not improve and may delay the diagnosis and treatment of acute appendicitis. Arch Surg 2001; 136: 556-62.
10. Namir Katkhouda, Rodney Mason et al- Laparoscopic versus open appendectomy, A prospective randomized double blind study, Annals of Surgery, September 2005,vol 242, number 3, 439-450.
11. Ali R, Khan MR, Pishori T, Tayeb M. Laparoscopic appendectomy for acute appendicitis: Is this a feasible option for developing countries ? Saudi J Gastroenterol 2010;16:25-9.
12. B V Goudar, Sunil etal. Laparoscopic versus open appendectomy: A Comparison of Primary outcome studies from Southern India. Journal of Clinical and Diagnostic Research 2011; Vol-5(8): 1606-1609.
13. Bushra Shirazi, Naureen Ali, Muhammad Shahid Shamim. Laproscopic versus open appendectomy: A comparative study. Journal of Pak Medical Assosciation 2010; 60:901.
14. Khalil J, Muqim M, Rafique M, Khan M. Laparoscopic versus open appendectomy : a comparison of the primary outcome measures. Saudi J Gastroenterol 2011;17:236-40.
15. Sauerland S, Jaschinski T, Neugebaner EA. Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database Syst Rev 2010;10: CD001546.Review.
16. Adrian. E. Ortega, et.al. A prospective randomized comparison of laparoscopic appendectomy with open appendectomy." Am. Jr. Surgery 1995; 169 :208-213.
17. Mc. Ahena OJ, O Austin PRO, Connell et al-"Laparoscopic V/ s Open Appendectomy" Br. J Surg 1992; 79 (8) : 818-820.
18. Heikkinen TJ, Haukipuro K, Hulkko A. Cost effective appendectomy. Open or laparoscopic ? A prospective randomized study. Surg Endosc 1998; 12: 1204-8
19. McCahill LE, Pellegrini CA, Wiggins T, Helton WS. A clinical outcome and cost analysis of laparascopic versus open appendectomy. Am J Surg 1996; 171 : 533-537.
Shailaja A, Jayaram A. Comparision of laparascopic versus open appendectomy in rural teaching hospital of Telangana. Perspectives in Medical Research 2019; 7(1):45-48.