OUTCOME OF OPEN VERSUS LAPROSCOPIC APPENDICECTOMY IN DEPARTMENT OF SURGERY, LADY READING HOSPITAL, PESHAWAR

Abstract

Objective: To compare safety and benefits of laparoscopic versus open appendicectomy in a randomizedcontrol clinical trial.Methodology: Between January 2008 and October 2009 one hundred and twenty patients (86 male and 34female) with suspected acute appendicitis were assigned either to laparoscopic [n=60] or open [n=60]appendicectomy. Surgical technique was standardized for both laparoscopic and open procedure. Thepatients were analyzed in terms of the following aspects and findings; operation time, postoperative pain,intra and post operative complications, hospital stay and return to normal daily activities.Results: There was no mortality. Wound infection (8.3%) and intra-abdominal abscess (11.6%) formationrate was significantly higher in open group than in the laparoscopic group (1.6%) and (3.3%) respectively.Postoperative pain scores (assessed by a pain distress variable, indicated on visual linear scale 0 to 10and a pain activity scale, indicated on visual linear scale 0 to 10) was significantly lower in laparoscopicgroup. Hospital stay was significantly shorter in laparoscopic group (p<0.0353) and mean operation timewas similar in both groups. One patient (1.6%) was converted from laparoscopic to open appendicectomydue to diffuse pelvic adhesions.Conclusion: Though operation time was same but complications, pain and hospital stay was less in theLaparoscopic group.