Superiority of Laparoscopic Appendectomy over Open Appendectomy: The Hyderabad Experience

Objective: To compare the out come of laparoscopic and open appendicectomies in terms of operative time, analgesic requirement, postoperative complications, hospital stay, return to normal activity and condition of scar. Methods: This prospective study was carried out in Department of Surgery, Liaquat University Hospital Hyderabad/Jamshoro from September 1997 to August 2000. One hundred consecutive patients of age ranging from 15-45 years with features suggestive of acute appendicitis were equally divided into laparoscopic appendectomy (LA) and open appendectomy (OA) groups, after taking informed consent. LA was done with the help of three trocar/cannulae creating pneumoperitoneum with CO2 whereas OA was performed by Lanz incision. The data were analyzed by Student t-test and Chi square tests using SPSS version 10. Results: The operating times in OA and LA were 20-70 minutes (mean 30) and 25-95 minutes (mean 55) respectively. Increased doses of analgesics, antibiotics and antiemetics were required in OA, as compared to LA. The mean postoperative hospital stay in LA group was 1.4 days (range 1-3 days) whereas it was in OA group, it was 3.5 days (range 2-6 days). Conclusion: LA is safe and has major benefits like less postoperative pain, decreased wound infection, early hospital discharged, early return to work and a better cosmetic scar than OA.