Comparison of the post-operative outcome of laparoscopic appendectomy(LA) and open appendectomy (OA) by analyzing the operative time, post-operative recovery and complications
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Keywords
Appendicitis, Laparoscopic Appendectomy, Open Appendectomy.
Abstract
The study aims to compare the post operative outcome of laparoscopic appendectomy(LA) and open appendectomy (OA) by analyzing the operative time, post-operative recovery and complications.
Methods; All children presented to department of paediatric surgery, Maternity and children hospital(MCH) Buraidah with acute appendicitis over a consecutive period of three years (Jan 2007 to Jan 2010) were included in the study. Operative time, analgesia, time to resume feed, complications and hospital stay were recorded retrospectively.
Results; 215 patients aged 3 to 12 years, underwent appendectomies. 101 had LA, 111 underwent OA and 3 were converted and excluded from further analysis. Mean operative time for LA was 72.62±24.16 versus 46.85±16.03 minutes in OA (P<0.001). Feed resumption was after 16.50 ±6.01h in LA and 27.02±15.64h in OA, (P < 0.001). Wound infections were 0.99% in LA and 6.30% in OA, (P = 0.042). There were 3.96% residual abscesses in LA and 4.5% in OA, P = 0. 844.Small bowel obstruction was 0.99% in LA and 5% in OA, P=0.123. Mean postoperative stay for LA was 2.98± 1.49days and 3.82±2.10 for OA, (P=0.001)
Conclusion: Early resumption of feeds, shorter hospital stay, lesser incidence of small bowel obstruction, comparable intra-abdominal abscess rate, and significantly less wound infection rate makes LA an attractive alternative to OA.
References
2. Naffis D. Laparoscopic appendectomy in children. Semin Pediatr Surg 1993; 2:174-7.
3. Aziz O, Athanasiou T, Tekkis PP, Purkayastha S, Haddow J, Malinovski V, et al. Laparoscopic versus open appendectomy in children. Ann Surg 2006; 243: 17-27
4. Barkhausen S, Wullstein C, Gross E. Laparoscopic versus Conventional appendectomy-a comparision with reference to early Post operative complications. Zentaralbl Chir 1998; 123: 858-62.
5. Prasad TR, Chui CH, Jacobsen AS. Laparoscopic appendicectomy in children. A trainee’s perspective. Ann Acad Med Singapore 2006; 35: 694-7.
6. Frazee RC, Roberts JW, Symmonds RE. A prospective randomized trial comparing open versus laparoscopic appendectomy. Ann Surg 1994; 219: 725-31.
7. Horwitz JR, Custer MD, May BH, Mehall JR, Lally KP. Should laparoscopic appendectomy be avoided for complicated appendicitis in children? J Pediatr Surg 1997; 32: 1601-3.
8. Valla JS, Steyaert H, Alain LJ. Management of appendicular peritonitis in children: Traditional surgery vs laparoscopy. Retrospective comparative study of pediatric video surgery group. Int J Ped Surg Sci 1996; 10: 13-6.
9. Mallick MS, Al-Qahtani A, Al-Bassam A. Laparoscopic appendectomy is a favorable alternative for complicated appendicitis in children. Pediatr Surg Int 2007; 23: 257-9.
10. York D, Smith A, von Allmen D, Phillips JD. Laparoscopic appendectomy in children after the learning curve. JSLS 2006; 10:447-52.
11. Hansen JB, Smithers BM, Schache D, Wall DR, Miller BJ, Menzies BL. Laparoscopic versus open appendectomy. World J Surg 1996; 20:17-21.
12. Kehagias I, Karamanakos SN, Panagiotopoulos S, Panagopoulos K, Kalfarentzos F. Laparoscopic versus open appendectomy: which way to go? World J Gastroenterol 2008;14:4909-14.
13. Caravaggio C, Hauters P, Malvaux P, Landenne J, Janssen P. Is laparoscopic appendectomy an effective procedure? Acta Chir Belg 2007; 107: 368-72.
14. Konstantinidis KM, Anastasakou KA, Vorias MN, Sambalis GH, Georgiou MK, Xiarchos AG. A decade of laparoscopic appendectomy: presentation of 1,026 patients with suspected appendicitis treated in a single surgical department. J Laparoendosc Adv Surg Tech A 2008; 18: 248-58.
15. Tsao KJ, St Peter SD, Valusek PA, Keckler SJ, Sharp S, Holcomb GW 3rd. Adhesive small bowel obstruction after appendectomy in children: comparison between the laparoscopic and open approach. J Pediatr Surg 2007; 42: 939-42.
16. Schmelzer TM, Rana AR, Walters KC, Norton HJ, Bambini DA, Heniford BT. Improved outcomes for laparoscopic appendectomy compared with open appendectomy in the pediatric population. J Laparoendosc Adv Surg Tech A 2007; 17:693-7.
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