Abstrakt

Evaluation of Laparoscopic Appendectomy vs. Open Appendectomy

 Muhammad Harris

 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